Insulin resistance in women with a history of severe pre-eclampsia.

Aim: This study investigated whether post-partum insulin resistance existed in women with a history of severe pre-eclampsia.

Methods: The euglycemic hyperinsulinemic clamp technique was used to assess insulin sensitivity at least 6 months after delivery in 13 women who had had severe pre-eclampsia and 26 age- and body mass index-matched controls who had had normal pregnancy.

Results: The mean (+/-SD) durations after delivery were 2.6 +/- 1.6 years and 4.5 +/- 2.8 years in the pre-eclampsia and control groups, respectively. The systolic blood pressure was significantly higher in the pre-eclampsia group (118 +/- 11 mmHg vs 109 +/- 12 mmHg, P = 0.028). Although the body mass indices were not different among the groups (25.8 +/- 3.1 kg/m(2) vs 24.6 +/- 3.9 kg/m(2)), the waist and waist-to-hip ratio were significantly higher in the women with prior pre-eclampsia. The pre-eclampsia group had lower insulin sensitivity index than the controls (5.4 +/- 2.5 mg/kg/min/mU/L vs 8.1 +/- 4.0 mg/kg/min/mU/L, P = 0.036). Serum triglyceride levels were significantly higher in the pre-eclampsia group (153 +/- 74 mg/dL vs 82 +/- 37 mg/dL, P < 0.01). High-density lipoprotein-cholesterol levels tended to be lower in the pre-eclampsia group (42.1 +/- 9.7 mg/dL vs 48.2 +/- 9.6 mg/dL, P = 0.07).

Conclusion: Women with a history of severe pre-eclampsia had characteristics of metabolic syndrome and had lower insulin sensitivity compared with those who had had normal pregnancy. These may explain an increased risk of cardiovascular disease in women with pre-eclampsia.