title: Insulin resistance relates to microvascular reactivity 23 years after preeclampsia.
abstract: Preeclampsia, an endothelial disorder of pregnancy, is associated with an increased risk on cardiovascular diseases. Cardiovascular risk factors may mediate vascular dysfunction both during pregnancy but also later in life. This study aims to investigate microvascular reactivity, and its relationship with several cardiovascular risk factors, in women with a history of preeclampsia and controls. In this cross-sectional study we compared women with a history of preeclampsia (PE, n=22) with women with uneventful pregnancies only (CON, n=29) 23 years after their first delivery. Participants were matched for BMI, age and date of delivery. We assessed blood concentrations of fasting glucose, HbA1c, insulin, (total, HDL-, LDL-) cholesterol, triglycerides and CRP. Endothelial function was assessed by measurement of skin microcirculatory blood flow by Laser Doppler flowmetry at the dorsal and ventral site of the finger during post-occlusive reactive hyperemia (PORH). PE had higher fasting insulin levels and HOMA-IR compared with CON. The PORH response was similar in both groups. The area under the curve of PORH correlated with insulin and HOMA-IR at both sites, with BMI, triglycerides at the dorsal site and with CRP at the ventral site of the finger in PE and not in CON. In conclusion, 23 years after pregnancy we did not observe a difference in the microvascular hyperemic response between women with a history of preeclampsia and controls. Meanwhile, the results of our study suggest that insulin resistance and other cardiovascular risk factors are related to microvascular reactivity in middle-aged women with a history of preeclampsia.
authors.affiliation: Department of Obstetrics & Gynecology, Maastricht University Medical Centre, Maastricht, the Netherlands. julia.spaan@og.unimaas.nl
authors.forename: Julia J
authors.initials: JJ
authors.lastname: Spaan
authors.forename: Alphons J H M
authors.initials: AJ
authors.lastname: Houben
authors.forename: Angela
authors.initials: A
authors.lastname: Musella
authors.forename: Timo
authors.initials: T
authors.lastname: Ekhart
authors.forename: Marc E A
authors.initials: ME
authors.lastname: Spaanderman
authors.forename: Louis L H
authors.initials: LL
authors.lastname: Peeters
mesh_terms: D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006940:Hyperemia / Q000097:blood / Q000503:physiopathology*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D017078:Laser-Doppler Flowmetry; D008833:Microcirculation; D055806:Microvessels / Q000503:physiopathology*; D008875:Middle Aged; D009426:Netherlands; D011225:Pre-Eclampsia / Q000503:physiopathology*; D011247:Pregnancy; D012867:Skin / Q000098:blood supply*; D013997:Time Factors; D014664:Vasodilation
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D002097:C-Reactive Protein; D002784:Cholesterol; D006442:Glycated Hemoglobin; D007328:Insulin; C517652:hemoglobin A1c protein, human