Konstantina Dipla1, Areti Triantafyllou2, Iris Grigoriadou3, Evangelia Kintiraki4, Georgios A Triantafyllou2, Pavlos Poulios2, Ioannis S Vrabas3, Andreas Zafeiridis3, Stella Douma2, Dimitrios G Goulis4. 1. Laboratory of Exercise Physiology and Biochemistry, Department of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Ippokratous 22, Agios Ioannis, Serres, 62110, Greece. kdipla@phed-sr.auth.gr. 2. Third Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece. 3. Laboratory of Exercise Physiology and Biochemistry, Department of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Ippokratous 22, Agios Ioannis, Serres, 62110, Greece. 4. Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynaecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Abstract
AIMS/HYPOTHESIS: Gestational diabetes mellitus (GDM) is a risk factor for the development of endothelial dysfunction and cardiovascular disease. However, in vivo microvascular endothelial function in GDM has not been investigated. This study aimed to examine, using near-infrared spectroscopy (NIRS), whether: (1) there are differences in microvascular reactivity and skeletal muscle oxygen consumption (m[Formula: see text]) at rest and during exercise between GDM and uncomplicated pregnancies; and (2) there is an association of NIRS indices with macrovascular function and cardiovascular disease risk factors. METHODS: Twenty-nine pregnant women (13 with GDM and 16 women with uncomplicated pregnancy, 28 ± 2 gestational weeks) underwent arterial stiffness (pulse wave velocity [PWV]) and 24 h ambulatory BP (24 h BP) evaluation. NIRS continuously monitored, non-invasively, changes in muscle oxygenated and deoxygenated haemoglobin and tissue O2 saturation index (TSI, %) during arterial occlusion/reperfusion and intermittent handgrip exercise. m[Formula: see text] and vascular reactivity indices were calculated. RESULTS: During occlusion and reperfusion, women with GDM exhibited slower TSI response (occlusion slope: -0.06 ± 0.02 vs -0.10 ± 0.04, in GDM and controls, respectively; reperfusion slope: 0.65 ± 0.26 vs 1.05 ± 0.41, respectively), lower m[Formula: see text] (1.3 ± 1.2 vs 3.8 ± 2.3 μmol l-1 min-1) and blunted hyperaemia (ΔTSI 6.8 ± 2.9 vs 9.5 ± 3.4) compared with controls (p < 0.01). Despite similar handgrip strength in the GDM and control groups (29.1 ± 8.1 vs 26.2 ± 10.4 kg, respectively), during repeated forearm contractions, women with GDM presented a blunted TSI response (6.5 ± 3.9 vs 19.2 ± 10.9; p < 0.01) and a reduced capacity to maintain the predetermined handgrip (23.4 ± 2.9 vs 27.4 ± 3.8%, p < 0.05). NIRS indices correlated with PWV, 24 h BP and blood glucose concentration earlier in pregnancy (r = 0.40-0.60; p < 0.05). CONCLUSIONS/ INTERPRETATION: Women with GDM exhibited a characteristic blunted TSI curve, showing alterations in muscle oxygenation and microvascular responsiveness compared with women with uncomplicated pregnancies. These alterations were manifested during exercise and possibly contribute to the reduced exercise tolerance in GDM. NIRS indices correlated with macrovascular indices (arterial stiffness) and 24 h BP.
AIMS/HYPOTHESIS: Gestational diabetes mellitus (GDM) is a risk factor for the development of endothelial dysfunction and cardiovascular disease. However, in vivo microvascular endothelial function in GDM has not been investigated. This study aimed to examine, using near-infrared spectroscopy (NIRS), whether: (1) there are differences in microvascular reactivity and skeletal muscle oxygen consumption (m[Formula: see text]) at rest and during exercise between GDM and uncomplicated pregnancies; and (2) there is an association of NIRS indices with macrovascular function and cardiovascular disease risk factors. METHODS: Twenty-nine pregnant women (13 with GDM and 16 women with uncomplicated pregnancy, 28 ± 2 gestational weeks) underwent arterial stiffness (pulse wave velocity [PWV]) and 24 h ambulatory BP (24 h BP) evaluation. NIRS continuously monitored, non-invasively, changes in muscle oxygenated and deoxygenated haemoglobin and tissue O2 saturation index (TSI, %) during arterial occlusion/reperfusion and intermittent handgrip exercise. m[Formula: see text] and vascular reactivity indices were calculated. RESULTS: During occlusion and reperfusion, women with GDM exhibited slower TSI response (occlusion slope: -0.06 ± 0.02 vs -0.10 ± 0.04, in GDM and controls, respectively; reperfusion slope: 0.65 ± 0.26 vs 1.05 ± 0.41, respectively), lower m[Formula: see text] (1.3 ± 1.2 vs 3.8 ± 2.3 μmol l-1 min-1) and blunted hyperaemia (ΔTSI 6.8 ± 2.9 vs 9.5 ± 3.4) compared with controls (p < 0.01). Despite similar handgrip strength in the GDM and control groups (29.1 ± 8.1 vs 26.2 ± 10.4 kg, respectively), during repeated forearm contractions, women with GDM presented a blunted TSI response (6.5 ± 3.9 vs 19.2 ± 10.9; p < 0.01) and a reduced capacity to maintain the predetermined handgrip (23.4 ± 2.9 vs 27.4 ± 3.8%, p < 0.05). NIRS indices correlated with PWV, 24 h BP and blood glucose concentration earlier in pregnancy (r = 0.40-0.60; p < 0.05). CONCLUSIONS/ INTERPRETATION:Women with GDM exhibited a characteristic blunted TSI curve, showing alterations in muscle oxygenation and microvascular responsiveness compared with women with uncomplicated pregnancies. These alterations were manifested during exercise and possibly contribute to the reduced exercise tolerance in GDM. NIRS indices correlated with macrovascular indices (arterial stiffness) and 24 h BP.
Authors: P Di Fulvio; A Pandolfi; G Formoso; S Di Silvestre; P Di Tomo; A Giardinelli; A De Marco; N Di Pietro; M Taraborrelli; S Sancilio; R Di Pietro; M Piantelli; A Consoli Journal: Nutr Metab Cardiovasc Dis Date: 2014-12 Impact factor: 4.222
Authors: Kennedy Cruickshank; Lisa Riste; Simon G Anderson; John S Wright; Graham Dunn; Ray G Gosling Journal: Circulation Date: 2002-10-15 Impact factor: 29.690
Authors: H Kawano; T Motoyama; O Hirashima; N Hirai; Y Miyao; T Sakamoto; K Kugiyama; H Ogawa; H Yasue Journal: J Am Coll Cardiol Date: 1999-07 Impact factor: 24.094
Authors: Isabelle Ea Pontes; Karine F Afra; José R Silva; Paulo Sn Borges; Geraldine F Clough; João Gb Alves Journal: Diabetol Metab Syndr Date: 2015-03-28 Impact factor: 3.320
Authors: Kristen E Boyle; Hyonson Hwang; Rachel C Janssen; James M DeVente; Linda A Barbour; Teri L Hernandez; Lawrence J Mandarino; Martha Lappas; Jacob E Friedman Journal: PLoS One Date: 2014-09-12 Impact factor: 3.240
Authors: Girish Rayanagoudar; Amal A Hashi; Javier Zamora; Khalid S Khan; Graham A Hitman; Shakila Thangaratinam Journal: Diabetologia Date: 2016-04-13 Impact factor: 10.122
Authors: S Pastorino; T Bishop; S R Crozier; C Granström; K Kordas; L K Küpers; E C O'Brien; K Polanska; K A Sauder; M H Zafarmand; R C Wilson; C Agyemang; P R Burton; C Cooper; E Corpeleijn; D Dabelea; W Hanke; H M Inskip; F M McAuliffe; S F Olsen; T G Vrijkotte; S Brage; A Kennedy; D O'Gorman; P Scherer; K Wijndaele; N J Wareham; G Desoye; K K Ong Journal: BJOG Date: 2018-10-22 Impact factor: 6.531
Authors: Caroline B Prudencio; Marilza V C Rudge; Fabiane A Pinheiro; Carlos I Sartorão Filho; Sthefanie K Nunes; Cristiane R Pedroni; Baerbel Junginger; Angélica M P Barbosa Journal: PLoS One Date: 2019-11-07 Impact factor: 3.240
Authors: Konstantina Dipla; Andreas Zafeiridis; Gesthimani Mintziori; Afroditi K Boutou; Dimitrios G Goulis; Anthony C Hackney Journal: Endocrines Date: 2021-03-26
Authors: Marieta P Theodorakopoulou; Maria Eleni Alexandrou; Dimitra Rafailia Bakaloudi; Georgia Pitsiou; Ioannis Stanopoulos; Theodoros Kontakiotis; Afroditi K Boutou Journal: ERJ Open Res Date: 2021-06-28