Twenty-Four Hour Urine Insulin as a Measure of Hyperinsulinaemia/Insulin Resistance Before Onset of Pre-Eclampsia and Gestational Hypertension
11/2005
Journal Article
Authors:
Emery, S.P.;
Levine, R.J.;
Quan, C.;
Ewell, M.;
England, L.J.;
Yu, K.F.;
Catalano, M.
Secondary:
BJOG
Volume:
112
Pagination:
1471-1528
URL:
http://www.ncbi.nlm.nih.gov/pubmed/16225566
Keywords:
Adult; Case-Control Studies; Circadian Rhythm; Female; Hyperinsulinism; Hypertension-Pregnancy-Induced; Insulin; Insulin Resistance; Pre-Eclampsia; Pregnancy; Pregnancy Complications
Abstract:
{OBJECTIVE: To evaluate levels of 24-hour urine insulin excretion before the onset of pre-eclampsia and gestational hypertension. DESIGN: Nested case-control study within the Calcium for Preeclampsia Prevention (CPEP) study cohort. SETTING: Five university medical centres in the United States. SAMPLE: Cases had developed pre-eclampsia (n= 70) or gestational hypertension (n= 142) in the absence of gestational diabetes. Controls (n= 429) had remained normotensive without gestational diabetes. METHODS: Subjects were required to have had an adequate baseline 24-hour urine collection prior to CPEP enrolment at 13-21 weeks. Controls were matched to cases by enrolment site and specimen storage time, without regard to gestational age or CPEP treatment. Adjusted mean 24-hour urine insulin excretion was, however, calculated using analysis of covariance, with adjustment models for pre-eclampsia considering body mass index, race and smoking status; and for gestational hypertension, gestational age at specimen collection, height, body mass index and smoking. Urine insulin was measured by radio-immunoassay. MAIN OUTCOME MEASURES: Twenty-four-hour urine insulin excretion. RESULTS: Adjusted 24-hour urine insulin excretion at baseline (mean 17 weeks of gestation) was greater in women who developed pre-eclampsia than in normotensive controls (mean [SE]: 15.6 [1.5] vs 13.1 [1.2] x 10(3)microIU/24 hour
