Markers of insulin resistance as predictors of hypertension in pregnancy
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 11
Abstract
Introduction: Insulin resistance, which has been linked to essential hypertension, may play a role in hypertension during pregnancy. We aimed to study the serum markers of insulin resistance in the first 20 weeks of gestation and see their correlation with onset of hypertension in pregnancy. Methodology: We designed a cross-sectional study of pregnant females who presented to the Obstetric clinic of Department of Obstetrics and Gynaecology, Topiwala National Medical College and BYL Nair Hospital, Mumbai from June 2011 till May 2014. All consecutive pregnant females who were in the first 20 weeks of gestation were included in the study. All subjects were investigated for serum markers of insulin resistance. These variables were compared among normotensive and hypertensive subjects and logistic regression analysis was done to identify predictors of hypertension in pregnancy. Results: We included 300 patients in our study, of which we identified 24 patients with hypertension. Fasting insulin, Hemostatic Model Assessment for insulin resistance (HOMA-IR), high sensitivity C reactive protein (hs-CRP), serum cholesterol and tumour necrosis factor (TNF) alpha were significantly different between hypertensive and normotensive study subjects. Additionally, we found fasting inulin (OR = 3.91, p = 0.02), HOMA-IR (OR = 2.57, p = 0.04) and CRP levels (OR = 1.12, p<0.01) to be good predictors of developing hypertension in pregnancy. Conclusions: Our study found that fasting insulin, HOMA-IR and hs-CRP were the significant predictors of hypertension in pregnancy. A multi-centric study with large sample size is needed to support our findings.
Authors and Affiliations
Dr. Roza Bardeskar, Dr. Tushar Raghuwanshi, Dr. Asha Dalal
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