title: Maternal insulin resistance and preeclampsia.
abstract: OBJECTIVE
  The purpose of this study was to determine whether mid-trimester insulin resistance is associated with subsequent preeclampsia.
  
  
  METHODS
  This was a secondary analysis of 10,154 nulliparous women who received vitamin C and E or placebo daily from 9-16 weeks gestation until delivery. Of these, 1187 women had fasting plasma glucose and insulin tested between 22 and 26 weeks gestation. Insulin resistance was calculated by the homeostasis model assessment of insulin resistance (HOMA-IR) and the quantitative insulin sensitivity check index.
  
  
  RESULTS
  Obese women were twice as likely to have a HOMA-IR result of ≥75th percentile. Hispanic and African American women had a higher percentage at ≥75th percentile for HOMA-IR than white women (42.2%, 27.2%, and 16.9%, respectively; P < .001). A HOMA-IR result of ≥75th percentile was higher among the 85 nulliparous women who subsequently had preeclampsia, compared with women who remained normotensive (40.5% vs 24.8%; adjusted odds ratio, 1.9; 95% confidence interval, 1.1-3.2). Quantitative insulin sensitivity check index results were similar to the HOMA-IR results.
  
  
  CONCLUSIONS
  Midtrimester maternal insulin resistance is associated with subsequent preeclampsia.
authors: Department of Obstetrics and Gynecology, University of Alabama, Birmingham, School of Medicine, Birmingham, AL 35249-7333, USA. jchauth@uab.edu
authors: John C
authors: JC
authors: Hauth
authors: Rebecca G
authors: RG
authors: Clifton
authors: James M
authors: JM
authors: Roberts
authors: Leslie
authors: L
authors: Myatt
authors: Catherine Y
authors: CY
authors: Spong
authors: Kenneth J
authors: KJ
authors: Leveno
authors: Michael W
authors: MW
authors: Varner
authors: Ronald J
authors: RJ
authors: Wapner
authors: John M
authors: JM
authors: Thorp
authors: Brian M
authors: BM
authors: Mercer
authors: Alan M
authors: AM
authors: Peaceman
authors: Susan M
authors: SM
authors: Ramin
authors: Marshall W
authors: MW
authors: Carpenter
authors: Philip
authors: P
authors: Samuels
authors: Anthony
authors: A
authors: Sciscione
authors: Jorge E
authors: JE
authors: Tolosa
authors: George
authors: G
authors: Saade
authors: Yoram
authors: Y
authors: Sorokin
authors: Garland D
authors: GD
authors: Anderson
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D009765:Obesity / Q000097:blood / Q000453:epidemiology; D010298:Parity; D011225:Pre-Eclampsia / Q000097:blood / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D044469:Racial Groups; D012680:Sensitivity and Specificity
chemical_list: D001786:Blood Glucose