Fibrinolytic dysfunction after gestation is associated to components of insulin resistance and early type 2 diabetes in latino women with previous gestational diabetes

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dc.contributor.authorMorimitsu, Lilian K.
dc.contributor.authorFusaro, Annunciata S.
dc.contributor.authorSanchez, Victor H.
dc.contributor.authorHagemann, Cristiane C. F.
dc.contributor.authorBertini, Anna Maria
dc.contributor.authorDib, Sergio A.
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2016-01-24T13:49:15Z
dc.date.available2016-01-24T13:49:15Z
dc.date.issued2007-12-01
dc.description.abstractAmong patients with metabolic syndrome (MS), atherosclerosis and abnormal fibrinolytic function are frequently present, mostly owing to an increase in plasminogen activator inhibitor-1(PAI-1). We analyze PAI-1 in pregnant women, both normal and with gestational diabetes (GDM) and postpartum regarding its correlation to MS surrogates. Clinical characteristics, glucose tolerance (100 g-OGTT), lipids, PAI-1 antigen, insulin sensitivity (HOMA-S), and pancreatic P-cell function (HOMA-B) were investigated in 34 women. Eleven had normal glucose tolerance (NGT) during pregnancy and 23 had GDM (all GAD antibodies-negative). All patients were studied at 28-34 weeks of gestation and 16-24 weeks after delivery (75 g-OGTT). Parameters of interest were determined using commercial test systems. During pregnancy, PAI-1 was not statistically different between NGT and GDM (47 +/- 25 ng/ml versus 47 +/- 28 ng/ml, p = 0.9). After gestation, 19 (56%) women had NGT (11 of them from previous NGT A group) and 15 (44%) had impaired glucose tolerance (IGT) or DM. the IGT (IGT + DM) group had higher PAI-1 (p = 0.01), which did not decreased after delivery NGT-NGT before and after delivery (47 +/- 25 ng/ml versus 6 +/- 5 ng/ml; p < 0.001), GDM-NGT (62 +/- 36 ng/ml versus 14 +/- 15 ng/ml; p = 0.001) and GDM-IGT (39 +/- 20 ng/ml versus 27 +/- 23 ng/ml; p = 0. 15). PAI-1 levels were positively correlated (p < 0.05) to total cholesterol (r, = 0.37), triglycerides (r,, = 0.48), fasting plasma glucose (r(s), = 0.52), 2-h plasma glucose in the OGTT (r(s) = 0.58) and were negatively correlated (p < 0.05) with HOMA-S (rs = -0.42) and HOMA-B (r, = -0.38). Fibrinolytic dysfunction is still present in GDM women and is associated with early development of IGT or T2DM. PAI correlated with surrogate markers of MS levels and may identify a group of women at risk for macroangiopathy. (c) 2007 Elsevier Ireland Ltd. All rights reserved.en
dc.description.affiliationUniversidade Federal de São Paulo, Ctr Diabet, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Ctr Diabet, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent340-348
dc.identifierhttp://dx.doi.org/10.1016/j.diabres.2007.04.013
dc.identifier.citationDiabetes Research and Clinical Practice. Clare: Elsevier B.V., v. 78, n. 3, p. 340-348, 2007.
dc.identifier.doi10.1016/j.diabres.2007.04.013
dc.identifier.issn0168-8227
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/30181
dc.identifier.wosWOS:000251492100006
dc.language.isoeng
dc.publisherElsevier B.V.
dc.relation.ispartofDiabetes Research and Clinical Practice
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.rights.licensehttp://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy
dc.subjectgestational diabetes mellitusen
dc.subjectPAI-1en
dc.subjectfibrinolytic dysfunctionen
dc.subjectimpaired glucose toleranceen
dc.subjectinsulin resistanceen
dc.titleFibrinolytic dysfunction after gestation is associated to components of insulin resistance and early type 2 diabetes in latino women with previous gestational diabetesen
dc.typeinfo:eu-repo/semantics/article
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