Is Gestational Diabetes a Mediator or Marker of Cardiovascular Risk?

Poor cardiovascular health (CVH) and gestational diabetes (GD) are each associated with a higher risk for cardiovascular disease (CVD), though whether GD mediates the link between prepregnancy CVH and CVD remains unclear. To clarify this relationship, a study investigated whether GD serves as a mediator or a marker in the association between prepregnancy CVH and midlife subclinical CVD, involving 1,052 women with a mean age of 28.6 years. The study found that lower prepregnancy CVH was associated with higher odds of gestational diabetes (GD) and coronary artery calcium (CAC) in midlife.

Women with lower CVH had increased GD risk (adjusted odds ratio: 1.8) and a greater likelihood of developing CAC (adjusted OR: 1.7) compared to those with higher CVH. GD mediated 6% of the association between prepregnancy CVH and incident CAC, suggesting a limited mediating role. These findings suggest…