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Assessment of endothelial function in pregnant women with preeclampsia and gestational diabetes mellitus by flow-mediated dilation of brachial artery

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To compare endothelial function, as assessed by flow-mediated dilation (FMD) in pregnant women with preeclampsia (PE), gestational diabetes mellitus (GDM) and healthy pregnant women.

Methods

We conducted a cross-sectional study of eighty women who were selected and divided into three groups: Group A comprising 42 pregnant women with PE, Group B (control) consisting of 19 normotensive pregnant women with no comorbidities and Group C consisting of 19 pregnant women with GDM. The women underwent FMD and the results were compared between groups. The data were obtained from the Center for Fetal Medicine, Hospital das Clínicas, Federal University of Minas Gerais, Brazil (CEMEFE-HC-UFMG) after approval by the Ethics and Research Committee on June 4, 2008 under no CAAE-0280.0.203.000-08.

Results

Nonparametric variance analysis showed no statistically significant difference between the characteristics of the three groups. The comparison between the results of the mean values of brachial artery FMD groups of pregnant women with preeclampsia (FMD = 5.36 ± 4.61 %), gestational diabetes (FMD = 9,18 ± 5.98 %) and pregnant women in the control group (FMD = 17.55 ± 8.35 %) showed that a statistically significant difference was found between groups using the Dunn test. The comparison between groups PE × GDM was not statistically significant. The group consisting of pregnant women with GDM associated with those with PE had significantly lower results for FMD (6.55 ± 5.33 %) than the control group (17.55 ± 8.35 %, p = 0.00).

Conclusions

The group consisting of pregnant women with GDM or PE showed results for FMD significantly lower than the control group, suggesting possible endothelial injury in these patients.

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References

  1. World Health Organization (2005) The World health report: make every mother and child count. World Health Organization, Geneva

    Google Scholar 

  2. Callow AD (1999) Endothelial dysfunction in atherosclerosis. In: Catravas JD, Callow AD, Ryan US (eds) Vascular endothelium: mechanisms of cell signaling. IOS Press, Knossos, pp 81–88

    Google Scholar 

  3. Cudihy D, Lee RV (2009) The pathophysiology of pré-ecalmpsia: current clinical concepts. J Obstet Gynaecol 29:576–582

    Article  CAS  PubMed  Google Scholar 

  4. De Vriese AS, Verbeuren TJ, Voorde JVV, Lameire NH, Vanhoutte PM (2000) Endothelial dysfunction in diabetes. Br J Pharmacol 130:963–974

    PubMed Central  PubMed  Google Scholar 

  5. Young BC, Levine RJ, Karumanchi SA (2010) Pathogenesis of preeclampsia. Annu Rev Pathol 5:173–192

    Article  CAS  PubMed  Google Scholar 

  6. Savvidou MD, Lut Geerts L, Nicolaides KH (2002) Impaired vascular reactivity in pregnant women with insulin-dependent diabetes mellitus. Am J Obstet Gynecol 186:84–88

    Article  PubMed  Google Scholar 

  7. Frijns CJ, Kappelle LJ, van Gijn J, Nieuwenhuis HK, Sixma JJ, Fijnheer R (1997) Soluble adhesion molecules reflect endothelial cell activation in ischemic stroke and in carotid atherosclerosis. Stroke 28:2214–2218

    Article  CAS  PubMed  Google Scholar 

  8. Harris RA, Nishiyama SK, Wray DW, Richardson RS, Russell S (2010) Ultrasound assessment of flow-mediated dilation. Hypertension 55:1075–1085

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  9. Quyyumi AA (1998) Endothelial function in health and disease: new insights into the genesis of cardiovascular disease. Am J Med 105:32S–339S

    Article  CAS  PubMed  Google Scholar 

  10. Puddu P, Puddu GM, Zaca F, Muscari A (2000) Endothelial dysfunction in hypertension. Acta Cardiol 55:221–232

    Article  CAS  PubMed  Google Scholar 

  11. Cohen RA (1995) The role of nitric oxide and other endothelium-derived vasoactive substances in vascular disease. Prog Cardiovasc Dis 38:105–128

    Article  CAS  PubMed  Google Scholar 

  12. Myatt L, Webster RP (2009) Vascular biology of preeclampsia. J Thromb Haemost 7:375–384

    Article  CAS  PubMed  Google Scholar 

  13. Wedel JC, Mandala M, Barron C, Bernstein I, Osol G (2009) Mechanisms underlying maternal venous adaptation in pregnancy. Reprod Sci 16:596–604

    Article  Google Scholar 

  14. Luksha L, Nisell H, Kublickiene K (2004) The mechanism of EDHF-mediated responses in subcutaneous small arteries from healthy pregnant women. Am J Physiol Regul Integr Comp Physiol 286:1102–1109

    Google Scholar 

  15. Gillham JC, Kenny LC, Baker PN (2003) An overview of endothelium-derived hyperpolarising factor (EDHF) in normal and compromised pregnancies. Eur J Obstet Gynecol Reprod Biol 109:2–7

    Article  CAS  PubMed  Google Scholar 

  16. Yinon Y, Kingdom JC, Odutayo A, Moineddin R, Drewlo S, Lai V, Cherney D, Hladunewich M (2010) Vascular dysfunction in women with a history of preeclampsia and intrauterine growth restriction: insights into future vascular risk. Circulation 122:1846–1853

    Article  CAS  PubMed  Google Scholar 

  17. Maynard SE, Min JY, Merchan J, Lim KH, Li J, Mondal S et al (2003) Excess placental soluble fms-like tyrosine kinase 1 (sFlt1) may contribute to endothelial dysfunction, hypertension, and proteinuria in preeclampsia. J Clin Invest 111:649–658

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  18. Gilbert JS, Ryan MJ, LaMarca BB, Sedeek M, Murphy SR, Granger JP (2008) Pathophysiology of hypertension during preeclampsia: linking placental ischemia with endothelial dysfunction. Am J Physiol Heart Circ Physiol 294:H541–H550

    CAS  PubMed  Google Scholar 

  19. Report of the National High Blood Pressure Education (2000) Program Working Group on high blood pressure in pregnancy. Am J Obstet Gynecol 183:S1–S22

    Article  Google Scholar 

  20. World Health Organization (1999) Definition, diagnosis and classification of diabetes mellitus and its complications: report of a WHO consultation. WHO, Geneva

    Google Scholar 

  21. Dørup I, Skajaa K, Sørensen KE (1999) Normal pregnancy is associated with enhanced endothelium-dependent flow-mediated vasodilation. Am J Physiol 276:H821–H825

    PubMed  Google Scholar 

  22. Quinton AE, Cook CM, Peek MJ (2007) A longitudinal study using ultrasound to assess flow-mediated dilatation in normal human pregnancy. Hypertens Pregnancy 26:273–281

    Article  PubMed  Google Scholar 

  23. Yoshida A, Nakao S, Kobayashi M, Kobayashi H (2000) Flow-mediated vasodilation and plasma fibronectin levels in preeclampsia. Hypertension 36:400–404

    Article  CAS  PubMed  Google Scholar 

  24. Brandão AH, Cabral MA, Leite HV, Cabral AC (2012) Endothelial function, uterine perfusion and central flow in pregnancies complicated by preeclampsia. Arq Bras Cardiol 99(4):931–935

    Article  PubMed  Google Scholar 

  25. Savvidou MD, Hingorani AD, Tsikas D, Frolich JC, Vallance P, Nicolaides KH (2003) Endothelial dysfunction and raised plasma concentrations of asymmetric dimethylarginine in pregnant women who subsequently develop preeclampsia. Lancet 361:1511–1517

    Article  CAS  PubMed  Google Scholar 

  26. García RG, Celedón J, Sierra-Laguado J, Alarcón MA, Luengas C, Silva F et al (2007) Raised C-reactive protein and impaired flow-mediated vasodilation precede the development of preeclampsia. Am J Hypertens 20:98–103

    Article  PubMed  Google Scholar 

  27. Pàez O, Alfie J, Gorosito M, Puleio P, de Maria M, Prieto N et al (2009) Parallel decrease in arterial distensibility and in endothelium-dependent dilatation in young women with a history of preeclampsia. Clin Exp Hypertens 31:544–552

    Article  PubMed  Google Scholar 

  28. Stehouwer CDA, Lambert J, Donker AJM, Van Hinsbergh VWM (1997) Endothelial dysfunction and pathogenesis of diabetic angiopathy. Cardiovasc Res 34:55–68

    Article  CAS  PubMed  Google Scholar 

  29. Anastasiou E, Lekakis JP, Alevizaki M, Papamichael CM, Megas J (1998) Impaired endothelium-dependent vasodilatation in women with previous gestational diabetes. Diabetes Care 21:2111–2115

    Article  CAS  PubMed  Google Scholar 

  30. Stanley JL, Sankaralingam S, Baker PN, Davidge ST (2010) Previous gestational diabetes impairs long-term endothelial function in a mouse model of complicated pregnancy. Am J Physiol Regul Integr Comp Physiol 299:R862–R870

    CAS  PubMed  Google Scholar 

  31. Dollberg S, Brockman DE, Myatt L (1997) Nitric oxide synthase activity in umbilical and placental vascular tissue of gestational diabetic pregnancies. Gynecol Obstet Invest 44:177–181

    Article  CAS  PubMed  Google Scholar 

  32. Calver AJ, Collier J, Vallance P (1992) Inhibition and stimulation of nitric oxide synthesis in the human forearm arterial bed of patients with insulin-dependent diabetes. J Clin Invest 90:2548–2554

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  33. Westermeier F, Puebla C, Veja JL, Farías M, Escudero C, Casanello P, Sobrevia L (2009) Equilibrative nucleoside transporters in fetal endothelial dysfunction in diabetes mellitus and hyperglycaemia. Curr Vasc Pharmacol 7:435–449

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

We declare that we have no conflict of interest. And that we have had full control of all primary data and we agree to allow the Journal to review our data if requested.

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Authors and Affiliations

  1. Fetal Medicine Center, “Hospital das Clínicas-Federal University of Minas Gerais” (CEMEFE-HC-UFMG), Rua Santa Catarina 1340/1301, Lourdes, Belo Horizonte, MG, CEP 30170081, Brazil

    Maria Fernanda Brandão de Resende Guimarães, Augusto Henriques Fulgêncio Brandão, Cezar Alencar de Lima Rezende, Antônio Carlos Vieira Cabral, Ana Paula Brum, Henrique Vitor Leite & Carolina Andrade Bragança Capuruço

  2. Women’s Health Program at the Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil

    Maria Fernanda Brandão de Resende Guimarães & Augusto Henriques Fulgêncio Brandão

  3. Department of Obstetrics and Gynecology at the Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil

    Cezar Alencar de Lima Rezende, Antônio Carlos Vieira Cabral, Ana Paula Brum & Henrique Vitor Leite

  4. Department of Pediatrics Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil

    Carolina Andrade Bragança Capuruço

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  1. Maria Fernanda Brandão de Resende Guimarães
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Correspondence to Maria Fernanda Brandão de Resende Guimarães.

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de Resende Guimarães, M.F.B., Brandão, A.H.F., de Lima Rezende, C.A. et al. Assessment of endothelial function in pregnant women with preeclampsia and gestational diabetes mellitus by flow-mediated dilation of brachial artery. Arch Gynecol Obstet 290, 441–447 (2014). https://doi.org/10.1007/s00404-014-3220-x

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  • DOI: https://doi.org/10.1007/s00404-014-3220-x

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