Circulating B-type Natriuretic Peptide in Women with and without Recent Gestational Diabetes.


eMediNexus    11 November 2017

A new study published in Clinical Endocrinology aimed to determine whether gestational glucose tolerance relates to N terminal fragment of its prohormone NT proBNP in the years after delivery. Here 340 women underwent a glucose challenge test GCT and an oral glucose tolerance test OGTT in pregnancy yielding 4 gestational glucose tolerance groups GDM n 105 gestational impaired glucose tolerance n 59 abnormal GCT with a normal OGTT n 98 and normal GCT with normal OGTT n 75 . At 3 years postpartum they underwent cardio metabolic characterization including measurement of estimated glomerular filtration rate eGFR adiponectin and NT proBNP and the OGTT was repeated which revealed 69 women with glucose intolerance pre diabetes diabetes . It was observed that at 3 years postpartum serum NT proBNP did not differ between the four original gestational glucose tolerance groups but progressively decreased across current glucose tolerance strata from normal to pre diabetes to diabetes. NT proBNP was found to be a negative predictor of pre diabetes diabetes. On the other hand the significant association of NT proBNP with current glucose intolerance was ultimately attenuated in a fully adjusted model exhibiting two independent determinants of NT proBNP eGFR. Hence it was inferred that serum NT proBNP relates to current glucose intolerance rather than preceding gestational dysglycemia. Therefore it was stated that the diabetic rather than vascular risk implications of NT proBNP predominate in young women.

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