INSULIN SENSITIVITY IN PREECLAMPSIA

Objective To investigate whether pre-eclampsia is associated with an e xaggeration of the insulin resistance seen in normotensive pregnancy. Design Minimal model analysis of a frequently sampled intravenous gluc ose tolerance test to assess insulin sensitivity. Setting Royal Matern ity Hospital, Belfast. Participants Eleven women with pre-eclampsia an d 11 matched normotensive pregnant women. Results Insulin sensitivity (S-I) was increased in the group with pre-eclampsia compared with the normotensive women (mean [+/-SEM]: 2.6 [0.4] vs 1.6 [0.2] 10(-4) min(- 1) per mU/L; P = 0.028). This was accompanied by a decrease in glucose effectiveness (S-G) (1.1 +/- 0.1 vs 1.7 +/- 0.1 10(-2) min(-1) P = 0. 006) in the pre-eclamptic women. In the normotensive group there was a significant inverse correlation between S-I and mean arterial blood p ressure (r = -0.65; P = 0.03), but no such relation existed in the gro up with pre-eclampsia. Conclusions As with other forms of secondary hy pertension, and unlike essential hypertension, the pathophysiology of pre-eclampsia is not associated with insulin resistance.