Insulin Sensitivity Measures Predict Preeclampsia

Two measures of insulin sensitivity can predict which pregnant women are at risk for developing preeclampsia. High plasma glucose levels following a glucose load have been seen in women destined to develop preeclampsia. However, not all studies have shown a positive association between insulin resistance and preeclampsia, perhaps because of the measures used to assess the former.

In the present study of 829 normotensive pregnant women, Dr. Annunziata Lapolla, from the University of Padua, Italy, and colleagues assessed the preeclampsia-predicting power of three insulin sensitivity indices: fasting homeostasis model assessment (ISHOMA), quantitative insulin sensitivity check index (ISQUICKI), and oral glucose insulin sensitivity (OGIS).

Glucose challenge testing and assessment of the three insulin sensitivity measures were performed at 16 to 20 weeks gestation and again at 26 to 30 weeks. The results of all three tests confirmed previous reports showing that insulin sensitivity drops as pregnancy progresses.

Overall, 6.4% of women developed preeclampsia. Both ISHOMA and ISQUIKI were significant predictors of preeclampsia with sensitivities ranging from 79% to 88% and specificities of 97%. By contrast, the association between OGIS and preeclampsia was weaker and "was not considered in the prediction of preeclampsia."

"Given their high sensitivity and specificity, these indices could be useful in predicting the development of preeclampsia in early pregnancy, before the disease becomes clinically evident," the authors conclude.
Hypertension 2006;47:449-453.

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