Introduction
The most common metabolic disorder in pregnancy is hyperglycemia
resulting from impaired blood glucose tolerance which is defined as
either pregestational (PGDM) or gestational diabetes mellitus
(GDM)1. Diabetes in pregnancy may cause many adverse
perinatal outcomes including fetal macrosomia, stillbirth, neonatal
hypoglycemia, preeclampsia and birth trauma2,3. The
incidence of diabetes in pregnancy varies substantially
across countries, ranging between 0.9% and 5.7% for PGDM and 1.8% and
25.4% for GDM4,5. Both type 2 PGDM and GDM could be
diagnosed by various screening methods including fasting plasma glucose
(FPG), HbA1c and oral glucose tolerance test (OGTT), but which one of
them is the most successful for the diagnosis is still controversial.
Epicardial fat tissue is located between the visceral pericardium and
myocardium and is usually distributed adjacent to the right
ventricle6,7. Proinflammatory vasoactive peptides,
tumor necrosis factor-α, interleukin-6 and anti-inflammatory substances
(adiponectin, omentin, adrenomedullin) are released from epicardial fat
tissue8,9. Furthermore, epicardial fat tissue
contributes to myocardial energy production6. In
recent years, measurement of epicardial fat thickness (EFT) in adults
has been frequently used to detect insulin
resistance10. It has been shown that there is a
correlation between EFT and cholesterol, adiponectin and diastolic blood
pressure11. Since EFT is not affected by changes in
skin and muscle tissue, it is thought to be more reliable than some
other measurements such as abdominal circumference12.
However, conditions related to EFT are not clearly demonstrated in
antenatal life as in non-pregnant adults. It has been proposed that
increase in maternal EFT in pregnant women might be related to
preeclampsia and vascular complications13,14.
Limited studies in the literature have shown that fetal EFT is higher in
pregnant women with diabetes15-18. However, in these
studies, the comparison of fetal EFT was conducted only in pregnancies
with PGDM or GDM. Due to the methodology of previous studies, it could
not be clarified whether there is a difference for fetal EFT values
between pregnancies with PGDM and GDM. Therefore, the aim of this study
is to identify whether fetal EFT differs in pregnant women with PGDM and
GDM and also to correlate fetal EFT values with demographic parameters
of diabetic pregnancies.