Potential of Metformin to Improve Cardiac Risk in Postpartum Women with Gestational Diabetes
ObjectivePregnancy is associated with an increase in total cholesterol, high density lipoproteins (HDL), and low-density lipoproteins (LDL). Postpartum, HDL and LDL decrease over the first 12 weeks postpartum. Oxidized LDL (ox-LDL) is a marker of oxidative stress-related inflammation, which is assoc...
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doaj-2bf3dda7d0fe48d7aa83d7ff6b12abe12020-11-24T20:53:04ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2017-10-01410.3389/fmed.2017.00180285986Potential of Metformin to Improve Cardiac Risk in Postpartum Women with Gestational DiabetesOscar A. Viteri0Mary Alice Sallman1Pauline M. Berens2Pamela D. Berens3Farah H. Amro4Maria S. Hutchinson5Susan M. Ramin6Sean C. Blackwell7Jerrie S. Refuerzo8Judith. A. Smith9Department of Obstetrics, Gynecology and Reproductive Sciences, UTHealth McGovern Medical School, Houston, TX, United StatesDepartment of Obstetrics, Gynecology and Reproductive Sciences, UTHealth McGovern Medical School, Houston, TX, United StatesDepartment of Obstetrics, Gynecology and Reproductive Sciences, UTHealth McGovern Medical School, Houston, TX, United StatesDepartment of Obstetrics, Gynecology and Reproductive Sciences, UTHealth McGovern Medical School, Houston, TX, United StatesDepartment of Obstetrics, Gynecology and Reproductive Sciences, UTHealth McGovern Medical School, Houston, TX, United StatesDepartment of Obstetrics, Gynecology and Reproductive Sciences, UTHealth McGovern Medical School, Houston, TX, United StatesDepartment of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, United StatesDepartment of Obstetrics, Gynecology and Reproductive Sciences, UTHealth McGovern Medical School, Houston, TX, United StatesDepartment of Obstetrics, Gynecology and Reproductive Sciences, UTHealth McGovern Medical School, Houston, TX, United StatesDepartment of Obstetrics, Gynecology and Reproductive Sciences, UTHealth McGovern Medical School, Houston, TX, United StatesObjectivePregnancy is associated with an increase in total cholesterol, high density lipoproteins (HDL), and low-density lipoproteins (LDL). Postpartum, HDL and LDL decrease over the first 12 weeks postpartum. Oxidized LDL (ox-LDL) is a marker of oxidative stress-related inflammation, which is associated with obesity and also with development of cardiovascular disease. Cardiovascular protection and weight loss are benefits from metformin, especially in women with diabetes. The objective of this study was to compare changes in lipid profiles and biomarkers for obesity during the initial 6 weeks postpartum between women with gestational diabetes mellitus (GDM) treated with metformin versus placebo.MethodsThis was a planned ancillary study of a randomized controlled trial compares metformin versus placebo in women with GDM for postpartum weight loss. Two 3 mL blood samples were collected within 24 h of delivery and 6 weeks postpartum immediately processed after collection then stored at −20°C until completion of clinical trial prior to analysis. Change in the median plasma concentrations of total cholesterol, HDL, ox-LDL, glucose, insulin, leptin, and unacylated ghrelin were compared between study groups.ResultsOf the 77 postpartum women were included, 35 received metformin and 42 received placebo. There was less of a reduction in HDL in the metformin group compared to placebo (−2.3 versus −7.5 mg/dL, p = 0.019). In addition, there was a greater reduction in ox-LDL in those receiving metformin (−12.2 versus −3.8 mg/dL, p = 0.038). No other differences were observed in the selected biomarkers evaluated.ConclusionBiomarker levels of HDL and ox-LDL were positively affected during the initial 6 weeks postpartum in GDM women treated with metformin. Additional studies with a longer duration of metformin treatment in the postpartum period are warranted to evaluate long-term potential benefits.http://journal.frontiersin.org/article/10.3389/fmed.2017.00180/fullmetforminhigh-density lipoproteinsoxidized-low-density lipoproteinsgestational diabetescardiac riskpostpartum |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Oscar A. Viteri Mary Alice Sallman Pauline M. Berens Pamela D. Berens Farah H. Amro Maria S. Hutchinson Susan M. Ramin Sean C. Blackwell Jerrie S. Refuerzo Judith. A. Smith |
spellingShingle |
Oscar A. Viteri Mary Alice Sallman Pauline M. Berens Pamela D. Berens Farah H. Amro Maria S. Hutchinson Susan M. Ramin Sean C. Blackwell Jerrie S. Refuerzo Judith. A. Smith Potential of Metformin to Improve Cardiac Risk in Postpartum Women with Gestational Diabetes Frontiers in Medicine metformin high-density lipoproteins oxidized-low-density lipoproteins gestational diabetes cardiac risk postpartum |
author_facet |
Oscar A. Viteri Mary Alice Sallman Pauline M. Berens Pamela D. Berens Farah H. Amro Maria S. Hutchinson Susan M. Ramin Sean C. Blackwell Jerrie S. Refuerzo Judith. A. Smith |
author_sort |
Oscar A. Viteri |
title |
Potential of Metformin to Improve Cardiac Risk in Postpartum Women with Gestational Diabetes |
title_short |
Potential of Metformin to Improve Cardiac Risk in Postpartum Women with Gestational Diabetes |
title_full |
Potential of Metformin to Improve Cardiac Risk in Postpartum Women with Gestational Diabetes |
title_fullStr |
Potential of Metformin to Improve Cardiac Risk in Postpartum Women with Gestational Diabetes |
title_full_unstemmed |
Potential of Metformin to Improve Cardiac Risk in Postpartum Women with Gestational Diabetes |
title_sort |
potential of metformin to improve cardiac risk in postpartum women with gestational diabetes |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Medicine |
issn |
2296-858X |
publishDate |
2017-10-01 |
description |
ObjectivePregnancy is associated with an increase in total cholesterol, high density lipoproteins (HDL), and low-density lipoproteins (LDL). Postpartum, HDL and LDL decrease over the first 12 weeks postpartum. Oxidized LDL (ox-LDL) is a marker of oxidative stress-related inflammation, which is associated with obesity and also with development of cardiovascular disease. Cardiovascular protection and weight loss are benefits from metformin, especially in women with diabetes. The objective of this study was to compare changes in lipid profiles and biomarkers for obesity during the initial 6 weeks postpartum between women with gestational diabetes mellitus (GDM) treated with metformin versus placebo.MethodsThis was a planned ancillary study of a randomized controlled trial compares metformin versus placebo in women with GDM for postpartum weight loss. Two 3 mL blood samples were collected within 24 h of delivery and 6 weeks postpartum immediately processed after collection then stored at −20°C until completion of clinical trial prior to analysis. Change in the median plasma concentrations of total cholesterol, HDL, ox-LDL, glucose, insulin, leptin, and unacylated ghrelin were compared between study groups.ResultsOf the 77 postpartum women were included, 35 received metformin and 42 received placebo. There was less of a reduction in HDL in the metformin group compared to placebo (−2.3 versus −7.5 mg/dL, p = 0.019). In addition, there was a greater reduction in ox-LDL in those receiving metformin (−12.2 versus −3.8 mg/dL, p = 0.038). No other differences were observed in the selected biomarkers evaluated.ConclusionBiomarker levels of HDL and ox-LDL were positively affected during the initial 6 weeks postpartum in GDM women treated with metformin. Additional studies with a longer duration of metformin treatment in the postpartum period are warranted to evaluate long-term potential benefits. |
topic |
metformin high-density lipoproteins oxidized-low-density lipoproteins gestational diabetes cardiac risk postpartum |
url |
http://journal.frontiersin.org/article/10.3389/fmed.2017.00180/full |
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