Abstract

DETERMINATION OF GLUCOSE, INSULIN AND HOMA-IR IN PATIENTS WITH PREECLAMPSIA IN EGYPTIAN WOMEN

Amal K. Seleem, Abdel Aziz A. A., Hosam Abdelfatah, El-Gharib M. S. A., Faeza El-Dahtory and Eatimad A. Basha*

Abstract

Background: Preeclampsia is characterized pregnancy-induced hypertension and proteinuria complicates 3 – 4% of pregnancies and thus is a leading cause of maternal and fetal morbidity and mortality. Objective: To determine the frequency of the glucose, insulin and HOMA-IR level in mild preeclampsia (MPE) and severe preeclampsia (SPE) at second trimester and to verify if the severity of preeclampsia would be associated with HOMA-IR level and to examine whether insulin resistance identifies subtypes of preeclampsia. Method: Casecontrol study included 60 women with Preeclampsia and 30 no preeclampsia normotensive women as control. Three groups were chosen; mild preeclampsia group consisted of 30 women, severe preeclampsia group 30and control group 30 women. All groups were matched strictly for gestational age at second trimester. Maternal blood samples for glucose and insulin collected from the patients at second trimester and compared. Results: Diagnosis criteria for the participants included blood pressure above 140/90 and proteinuria above 300mg. Mean ages of participants, gestational week and weight were similar. Homa-Irand rate of insulin resistance was calculated by HOMA-IR and patients were followed up. Homeostatic model assessments [HOMA-IR] revealed that the average insulin resistance increased during pregnancy among both the case and control groups. There was a significant difference between insulin resistances of these two groups after developing preeclampsia [P < 0.001]. Conclusion: Insulin-resistance of the groups with preeclampsia was higher compared to natural pregnancy under similar conditions. Measurement of insulin resistance may be useful in predicting the risk of preeclampsia. Recommendation: It is tempting to consider that improving insulin sensitivity in high-risk women before and during early pregnancy may reduce the risk of preeclampsia taking into consideration other metabolic syndromes; however, the power calculation of the sample was low, suggesting that a larger sample needed.

Keywords: Preeclampsia, glucose, insulin, HOMA-IR.