Title

Insulin metabolic syndrome in postpartum women who had gestational diabetes or healthy pregnancies

Date of Award

1997

Availability

Article

Degree Name

Doctor of Philosophy (Ph.D.)

Department

Clinical Psychology

First Committee Member

Neil Schneiderman, Committee Chair

Second Committee Member

Jay Skyler, Committee Member

Abstract

Insulin metabolic syndrome, a cluster of CAD risk factors, comprises insulin resistance and compensatory hyperinsulinemia, glucose intolerance, dyslipidemia, hypertension and obesity. Pregnancy is a state of increased insulin resistance which unmasks vulnerability to these risk factors in some women. Women with a history of gestational diabetes (GD) are at higher risk of later developing diabetes and hypertension. This study examines features of insulin metabolic syndrome in this population of 48 healthy young postpartum women, 23 with history of GD and 25 normals, to assess group differences on these measures and to see whether these risk factors are clustered in this population. Analyses control for older age in the GD group.Although having normal glucose tolerance, women with a history of GD were more obese, had higher insulin resistance, and higher glucose response to oral challenge than normals (p $<$.01). They also revealed trends for higher triglycerides, standing DBP, fasting and 90 min glucose, glucose sum, and waist-hip ratio (p $<$.10). Insulin resistance was significantly correlated with glucose and insulin values, lipid levels, and SBP measures. Blood pressures reliably correlated with fasting insulin, BMI, LDL, and total cholesterol. BMI was reliably associated with glucose, but not insulin values. Total cholesterol and LDL were significantly associated with glucose and insulin values; insulins also correlated with HDL and triglycerides.Thus, enduring differences on aspects of insulin metabolic syndrome postpartum indicate that GD indicates an essential vulnerability of these women to atherosclerosis and CAD. Correlations among features of insulin metabolic syndrome are consistent with a cluster of co-occurring risk factors for atherosclerosis and CAD. Efforts to reduce morbidity and mortality from the world and nation's leading cause of death would do well to target populations at risk, such as women who have developed gestational diabetes, in order to improve their risk status.

Keywords

Health Sciences, Obstetrics and Gynecology; Health Sciences, Pathology; Psychology, Physiological

Link to Full Text

http://access.library.miami.edu/login?url=http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:9805966