Early identification of vascular changes in gestational diabetes mellitus (GDM) remains important for assessing cardiovascular risk during pregnancy. A prospective study published in the Journal of Diabetes and Its Complications evaluated the use of radiofrequency data-based quantitative vessel stiffness (R-QVS) analysis combined with vector flow imaging (VFI) to assess carotid artery structure and function in pregnant women with GDM.
The study included 117 pregnant women with GDM between 24 and 40 weeks of gestation and 45 healthy pregnant women as controls. Based on carotid intima-media thickness (CIMT), patients with GDM were classified into normal CIMT (n=63) and thickened CIMT (n=54) groups. All participants underwent multimodal carotid ultrasound. Structural parameters included vessel diameter (Diam), distensibility (Dist), hardness coefficient (HC), and pulse wave velocity (PWV), while functional parameters included maximum wall shear stress (WSSmax), mean wall shear stress (WSSmean), and maximum flow velocity (Vmax).
Significant differences were observed across groups for all structural and functional parameters (p<0.01). CIMT was higher in the thickened GDM group (1.15±0.17 mm) compared with the normal CIMT group (0.76±0.10 mm) and controls (0.62±0.12 mm). The thickened CIMT group also showed higher Diam (7.72±0.94 mm), PWV (8.67±0.82 m/s), and HC (5.14±0.72) (p<0.01). Receiver operating characteristic analysis showed higher diagnostic performance for PWV (AUC 0.87) and HC (AUC 0.85), while WSSmax (AUC 0.90) and WSSmean (AUC 0.84) also demonstrated good discrimination. Diam and Vmax showed lower AUC values (0.73 and 0.69).
Multivariable analysis identified PWV (β=0.364, p=0.011), HC (β=0.217, p=0.033), WSSmean (β=−0.150, p=0.039), and WSSmax (β=−0.112, p=0.065) as factors associated with CIMT. These findings show changes in vascular function parameters, including PWV and WSS, alongside structural alterations in GDM. Combined R-QVS and VFI provide a noninvasive method to evaluate carotid vascular changes.
