Insulin Resistance Is Associated with Gestational Hypertension and Not with Preeclampsia: A Population-Based Screening Study

Abstract

Aims: To investigate the relationship between insulin resistance (IR) and subsequent gestational hypertension (GH) or preeclampsia (PE) in normoglycemic and in gestational diabetic pregnant women. Furthermore, we tested whether this association was independent of the prepregnancy body mass index (BMI). Methods: Each participant underwent a 75-gram oral glucose tolerance test (OGTT) according to World Health Organization recommendation criteria with determination of serum glucose and C-peptide concentrations. IR was determined as a C-peptide-to-glucose ratio at the fasting (FCGR) state and at 2 h (2CGR) after load. Results: A total of 2,954 women were included with a singleton pregnancy, delivery at term, no chronic hypertension, and data on both glucose and C-peptide. Of these women, 183 (6.2%) developed GH and 49 (1.7%) PE. Gestational diabetes mellitus (GDM) was diagnosed in 6.0% of the participants. The FCGR and 2CGR were significantly higher in all women with GH, irrespective of their BMI, compared to the normotensive group; however, the PE and the normotensive groups had similar FCGR and 2CGR values. Conclusions: The present study suggests that IR at the OGTT is associated with the later development of GH; on the other hand, it is not associated with PE. These relationships are independent of the maternal BMI.

The Impact of Diagnostic Criteria for Gestational Diabetes Mellitus on Adverse Maternal Outcomes: A Systematic Review and Meta-Analysis

“…In addition, 34.69% of the studies were conducted in the U.S. [22,24,25,31,33,34,[36][37][38]41,44,52,53,55,57,58,64], 14.2% in Australia [20,27,28,50,51,65,68], 28.5% in Asia [26,29,32,35,39,40,42,[46][47][48][49]60,63,66], and 22.4% in Europe [21,23,30,43,45,54,56,59,61,62,67].…”

The Area under the Curve (AUC) of Oral Glucose Tolerance Test (OGTT) Could Be a Measure Method of Hyperglycemia in All Pregnant Women

“…Previous studies have shown similar comprehensive results. A cohort study including 2954 singleton pregnancies suggested that insulin resistance on an OGTT was associated with later development of gestational hypertension, but not preeclampsia, independent of maternal BMI [21]. Another study suggested that women who develop pregnancy-induced hypertension may be metabolically challenged at early stages of pregnancy with hyperinsulinism and insulin insensitivity [22].…”

Sex Differences in Hypercortisolism and Glucose-Metabolism Disturbances in Patients with Mild Autonomous Cortisol Secretion: Findings From a Single Center in China

“…FCGR is a measure of the amount of insulin secreted for a corresponding glucose level, and is considered a simplified index in the evaluation of insulin resistance compared with the euglycemic hyperinsulinemic clamp, which was regarded as the previous “gold standard”. In the study by Wang ( 28 ) and some other investigators ( 26 , 27 , 29 ), the fCGR index significantly increased in individuals with insulin resistance, and it was reported to present satisfactory specificity and sensitivity compared with euglycemic hyperinsulinemic clamps and HOMA indices. The results of our study therefore suggest that the level of insulin resistance in female MACS patients improves with the decline in autonomous cortisol secretion, and that this relationship only appears in premenopausal women with MACS and who manifest overt increases in autonomous cortisol secretion.…”