Body composition and energy metabolism in normotensive and hypertensive pregnancy.
OBJECTIVE
To determine whether the insulin resistance syndrome and altered body composition are features of hypertensive pregnancy.


METHODS
Women were recruited in the third trimester of pregnancy from the antenatal clinic, day assessment unit, and maternity ward of St George Hospital, Sydney.


METHODS
Women with pre-eclampsia (n = 12), gestational hypertension (n = 12), essential hypertension in pregnancy (n = 11), and normotensive pregnancy (n = 10).


METHODS
Energy metabolism was assessed by indirect calorimetry to measure basal metabolic rate and diet-induced thermogenesis. Body composition was measured as lean body mass, total body water and fat mass by bio-electrical impedance. Blood was collected for measurement of glucose, insulin and lipid profiles. Insulin resistance was indirectly assessed by the insulin and glucose concentrations and diet-induced thermogenesis.


RESULTS
Women with essential hypertension and gestational hypertension were heavier than women with normotensive pregnancies both pre-pregnancy and in the third trimester, whereas women with pre-eclampsia were similar to those with normotensive pregnancy. Women with essential hypertension were otherwise similar to normotensive pregnancy but women with gestational hypertension had a reduced diet-induced thermogenesis and almost double insulin levels. Women with pre-eclampsia had a similar body composition and insulin levels but reduced basal metabolic rate, diet-induced thermogenesis and glucose levels compared with normotensive pregnancy.


CONCLUSIONS
Women who develop gestational hypertension, but not pre-eclampsia, are more likely to be overweight. Women with essential hypertension are similar to women with normotensive pregnancy throughout pregnancy. Both gestational hypertension and pre-eclampsia appear to be associated with some degree of insulin resistance, greater than that occurring in normal pregnancy.
Martin
A
A
Department of Renal Medicine, St George Hospital and University of New South Wales, Sydney, Australia.
O'Sullivan
A J
AJ
Brown
M A
MA
D000328:Adult; D000704:Analysis of Variance; D001823:Body Composition / Q000502:physiology*; D002151:Calorimetry; D003430:Cross-Sectional Studies; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000378:metabolism*; D007333:Insulin Resistance; D011225:Pre-Eclampsia / Q000378:metabolism; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000378:metabolism*; D011263:Pregnancy Trimester, Third