Total Sialic Acid and Associated Elements of the Metabolic Syndrome in Women With and Without Previous Gestational Diabetes
- Mohanaluxmi Sriharan, BSC1,
- Angela J. Reichelt, MD, PHD2,
- Maria Lúcia R. Opperman, MD3,
- Bruce B. Duncan, MD, PHD4,
- Sotero S. Mengue, PHD4,
- Martin A. Crook, MB, PHD5 and
- Maria I. Schmidt, MD, PHD4
- 1Guy’s, King’s, and St. Thomas’ Hospitals School of Medicine, King’s College London, London, U.K.
- 2Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- 3Department of Obstetrics and Gynecology, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- 4Department of Social Medicine, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- 5Department of Chemical Pathology, St. Thomas’ Hospital, London, U.K
Abstract
OBJECTIVE—Inflammatory markers predict type 2 diabetes and relate to the metabolic syndrome. Gestational diabetes mellitus (GDM) predicts type 2 diabetes and may be part of this syndrome. To examine the association of inflammatory markers with GDM, we investigated total sialic acid (TSA) in women with and without previous GDM.
RESEARCH DESIGN AND METHODS—All women with GDM and a random sample of women from one center of the Brazilian Study of Gestational Diabetes were invited to return 7 years after their index pregnancy. After an interview, an oral glucose tolerance test and anthropometry were performed. A total of 46 women with and 50 women without previous GDM completed the protocol.
RESULTS—Mean TSA was significantly higher in women with (71.8 ± 11.1 mg/dl) than without (67.5 ± 9.8 mg/dl) previous GDM (P < 0.05). In a linear regression model, TSA was 4 mg/dl (P < 0.05) higher in women with previous GDM, after adjustment for BMI, fasting insulin sensitivity, and number of years spent in school. In a similar model, current 2-h plasma glucose levels were associated with higher TSA levels after adjustment for waist-to-hip ratio and the log of triglycerides. TSA was strongly correlated with individual components and aggregates (r = 0.55, P < 0.001) of the metabolic syndrome.
CONCLUSIONS—Increased TSA levels are associated with previous GDM and are strongly linked to the metabolic syndrome. These findings in young women suggest that a chronic mild systemic inflammatory response is an early feature of the metabolic syndrome and that GDM may be a window for its investigation.
- GDM, gestational diabetes mellitus
- OGTT, oral glucose tolerance test
- TSA, total sialic acid
- WHO, World Health Organization
Footnotes
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Address correspondence and reprint requests to Dr. Maria I. Schmidt, Department of Social Medicine, School of Medicine, UFRGS, Rua Ramiro Barcelos 2600/414, Porto Alegre, RS 90035–003, Brazil. E-mail: bbduncan{at}orion.ufrgs.br.
Received for publication 19 February 2002 and accepted in revised form 24 April 2002.
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