Microvascular disease during pregnancy in type 1 diabetes is associated with ambulatory arterial stiffness

OBJECTIVES: The objective of this study was to evaluate the association between the ambulatory arterial stiffness index (AASI) and markers of microvascular disease during pregnancy in women with type 1 diabetes. STUDY DESIGN: A total of 151 women with type 1 diabetes mellitus were recruited for repeat 24-h BP recordings thrice during pregnancy and once three months post partum. Fifty women without diabetes served as controls. The AASI and pulse pressure (PP) were computed from blood pressure recordings. Repeated measures analysis of variance was used for comparison between groups during and after pregnancy. Linear regression analysis was performed with AASI and PP as dependent variables and albuminuria and retinopathy as independent variables. MAIN OUTCOME MEASURES: AASI during diabetic pregnancy and association with microvascular disease. RESULTS: Micro- or macroalbuminuria was present in 23% of the women and 58% had either simplex or proliferative retinopathy. The AASI was inversely associated with the coefficient of determination, which means that the stiffer vascular wall the more random variability in BP. CONCLUSION: AASI showed a strong association with microvascular disease during pregnancy in women with type 1 diabetes. Together with the flattened circadian rhythm this indicates a pregnancy-related functional change in the vascular bed.