Midpregnancy serum C-peptide concentration and subsequent pregnancy-induced hypertension.
OBJECTIVE
To test the hypothesis that elevated midpregnancy serum insulin (IRI) and C-peptide (CP) concentrations are associated with later development of pregnancy-induced hypertension (PIH), independent of prepregnancy obesity and midpregnancy blood pressure.


METHODS
In this prospective study, a cohort of normotensive women, ages > or = years performed a 50-g glucose challenge test at 24-30 weeks' gestational age. Blood samples were collected after an overnight fast and 1 h after glucose ingestion. Serum IRI and CP concentrations were measured in each sample. Maternal height, blood pressure and proteinuria were measured at the time of glucose challenge testing and after 36 weeks' gestational age.


RESULTS
Of 320 subjects enrolled 44 women (13.8%) had subsequent PIH. Crude odds ratios (ORs) for devevelopment of PIH associated with each 1 U rise in log fasting IRI, log lasting CP. and glucosed-induced increase in CP (expressed as log [postprandial CP/fasting CP]) were 2.0 (95% CI 1.3-3.3), 1.8 (CI 1.2-2.7), and 2.3 (CI 1.1-4.9) respectively. After controlling for prepregnancy BMI, gestational age, and midpregnancy mean arterial pressure, adjusted ORs corresponding to log fastig IRI and CP for the development of PIH were 1.3 (95% CI 0.7-2.3) and 1.7 (CI 1.1-2.7) respectively, and, afterq adjustment for fasting CP, the adjusted OR of the glucose-induced rise in log CP was 3.7 (CI 1.5-9.3).


CONCLUSIONS
Mid-pregnancy tasting and postoral glucose CP levels are associated with subsequent development of PIH, independent of maternal obesity and midpregnancy baseline blood pressure. These findings many reflect an amplified beta3-cell response to glycemic stimulus, similar to that found in states of insulin resistance, that appears to be independently associated with PIH.
Yasuhi
I
I
Department of Obstetrics and Gynecology, Brown University School of Medicine, Providence, Rhode Island, USA. yasuhi@net.nagasaki-u.ac.jp
Hogan
J W
JW
Canick
J
J
Sosa
M B
MB
Carpenter
M W
MW
D000328:Adult; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D002096:C-Peptide / Q000097:blood*; D015331:Cohort Studies; D005006:Ethnicity; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology*; D007328:Insulin / Q000097:blood*; D019518:Postprandial Period; D011237:Predictive Value of Tests; D011247:Pregnancy / Q000097:blood / Q000502:physiology*; D011249:Pregnancy Complications, Cardiovascular / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology*; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies; D044469:Racial Groups; D012237:Rhode Island
D015415:Biomarkers; D002096:C-Peptide; D007328:Insulin