399-P: Associations among Biomarkers of Inflammation, Tubular Injury, and Lipid Metabolism with Gestational Diabetes Mellitus (GDM) Status, Microalbuminuria, and Retinopathy in the MARIGOLD Study

Levels of hyperglycemia below those for diagnosis of diabetes are associated with microvascular injury, though the duration required to induce these complications remains poorly understood. This is especially relevant in patients with GDM due to its transient nature, which can nevertheless predispose to microvascular disease. Our aim was to assess whether mechanistic pathways associated with microvascular complications are upregulated in pregnant women with GDM or microvascular disease. In this analysis, urinary albumin excretion and biomarkers of inflammation, lipoprotein metabolism, and tubular injury were quantified in 355 women at 32-40 weeks of gestation, with and without GDM. Adjusted associations between all biomarkers and each outcome variable - GDM status, microalbuminuria, and retinopathy - were performed using logistic regression. Significant associations between GDM status and ApoA1, Il-6, IL-8, sTNFR I/II, NGAL, VEGF and vWF were observed (Figure 1A) . Increased CRP and sTNFR-II were associated with higher levels of albuminuria (Figure 1B) . CRP (Figure 1C) and previous GDM were associated with retinopathy. In conclusion, GDM and its relatively short-term exposure to hyperglycemia are associated with pathways involved in diabetes and microvascular complications. Disclosure H.Liu: None. B.R.Shah: None. V.S.Sridhar: None. L.Lovblom: None. D.Feig: Advisory Panel; Novo Nordisk, Research Support; Apotex. E.Herer: None. A.Kiss: None. L.Lipscombe: n/a. P.M.Yip: None. D.Cherney: Other Relationship; AbbVie Inc., AstraZeneca, Bayer AG, Boehringer Ingelheim International GmbH, Janssen Research & Development, LLC, Lilly, Maze, BMS, CSL-Behring, Merck, Otsuka, Novartis and Novo-Nordisk , Mitsubishi Tanabe Pharma Corporation, Sanofi, Research Support; Boehringer Ingelheim-Lilly, Merck, Janssen, Sanofi, AstraZeneca and Novo-Nordisk.