Insulin Resistance Linked to Increased Preeclampsia Risk

Nulliparous women with preeclampsia have higher insulin resistance than normotensive controls

MONDAY, April 18 (HealthDay News) -- Mid-trimester maternal insulin resistance is associated with subsequent preeclampsia, according to a study published in the April issue of the American Journal of Obstetrics & Gynecology.

John C. Hauth, M.D., from the University of Alabama at Birmingham, and colleagues investigated whether mid-trimester insulin resistance was correlated with subsequent preeclampsia in 1,187 nulliparous women who took vitamin C and E or placebo daily from nine to 16 weeks of gestation until delivery. Fasting plasma glucose and insulin were tested between 22 and 26 weeks of gestation. Insulin resistance was calculated by the quantitative insulin sensitivity check index (QUICKI) and the homeostasis model assessment of insulin resistance (HOMA-IR).

The investigators found that insulin and glucose levels did not differ between women in the vitamin- and placebo-treated groups, with obese women twice as likely to have a HOMA-IR result greater than or equal to the 75th percentile. A higher percentage of Hispanic and African-American women had HOMA-IRs greater than or equal to the 75th percentile compared to white women (42.2, 27.2, and 16.9 percent, respectively). The 85 nulliparous women who subsequently had preeclampsia had a higher HOMA-IR result -- greater than or equal to the 75th percentile -- compared to women who remained normotensive (40.5 versus 24.8 percent; adjusted odds ratio, 1.9). QUICKI results were similar to those of HOMA-IR.

"After the data were controlled for body mass index, race, ethnicity, treatment group, enrollment blood pressure, and gestational age at sampling, mid-trimester fasting HOMA-IR results of greater than or equal to 75th percentile and QUICKI of less than 25th percentile remain significant risk factors for subsequent preeclampsia," the authors write.

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