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(Hypertension. 2006;47:449.)
© 2006 American Heart Association, Inc.

Original Articles

Preeclampsia in Lean Normotensive Normotolerant Pregnant Women Can Be Predicted by Simple Insulin Sensitivity Indexes

Elena Parretti; Annunziata Lapolla; MariaGrazia Dalfrà; Giovanni Pacini; Andrea Mari; Riccardo Cioni; Chiara Marzari; Gianfranco Scarselli; Giorgio Mello

From the Department of Gynecology, Perinatology and Human Reproduction (E.P., R.C., G.S., G.M.), University of Florence; the Department of Medical and Surgical Sciences (A.L. M.G.D.), University of Padua; and the Metabolic Unit (G.P., A.M.), Institute of Biomedical Engineering, and Aging Branch (C.M.), Institute of Neuroscience, National Research Council, Padua, Italy.

Correspondence to Annunziata Lapolla, Dept of Medical and Surgical Sciences, University of Padua, Via Giustiniani n 2, 35100 Padova, Italy. E-mail annunziata.lapolla{at}unipd.it

Certain similarities between preeclampsia and insulin resistance syndrome suggest a possible link between the 2 diseases. The aim of our study was to evaluate 3 insulin sensitivity (IS) indexes (fasting homeostasis model assessment IS [IS_HOMA], quantitative insulin sensitivity check index [IS_QUICKI], and oral glucose IS [OGIS]) early and late in pregnancy in a large number of normotensive pregnant women with a normal glucose tolerance and to test the ability of these indexes to predict the risk of subsequent preeclampsia. In all, 829 pregnant women were tested with a 75-g, 2-hour oral glucose load in 2 periods of pregnancy: early (16 to 20 weeks) and late (26 to 30 weeks). In early and late pregnancy, respectively, IS_HOMA was 1.23±0.05 and 1.44±0.05 (P<0.01), IS_QUICKI was 0.40±0.002 and 0.38±0.002 (P<0.01), and OGIS was 457±2.4 mL min^–1 m^–2 and 445±2.2 (P<0.001), all confirming the reduction in insulin sensitivity during pregnancy. Preeclampsia developed in 6.4% of the pregnant women and correlated positively with the 75th centile of IS_HOMA (P=0.001), with a sensitivity of 79% in the early and 83% in the late period and a specificity of 97% in both. IS_QUICKI <25th centile was also related with preeclampsia (P=0.001), with a sensitivity of 85% in the early and 88% in the late period and a specificity of 97% in both. Judging from our findings, IS_HOMA and IS_QUICKI are simple tests that can pinpoint impaired insulin sensitivity early in the pregnancy. Given their high sensitivity and specificity, these indexes could be useful in predicting the development of preeclampsia in early pregnancy, before the disease become clinically evident.

Key Words: pregnancy • metabolism • insulin • insulin resistance • hypertension, pregnancy • preeclampsia

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Insulin Resistance in Preeclampsia

James M. Roberts and Hilary Gammill
Hypertension 2006 47: 341-342. [Extract] [Full Text] [PDF]

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