Objective: To investigate whether pre-eclampsia is associated with an exaggeration of the insulin resistance seen in normotensive pregnancy.
Design: Minimal model analysis of a frequently sampled intravenous glucose tolerance test to assess insulin sensitivity.
Setting: Royal Maternity Hospital, Belfast.
Participants: Eleven women with pre-eclampsia and 11 matched normotensive pregnant women.
Results: Insulin sensitivity (S(I)) was increased in the group with pre-eclampsia compared with the normotensive women (mean [+/-SEM]: 2.6 [0.4] vs 1.6 [0.2] 10(-4) min(-1) per mU/L; P = 0.028). This was accompanied by a decrease in glucose effectiveness (SG) (1.1+/-0.1 vs 1.7+/-0.1 10(-2)min(-1), P = 0.006) in the pre-eclamptic women. In the normotensive group there was a significant inverse correlation between S(I)and mean arterial blood pressure (r = -0.65; P = 0.03), but no such relation existed in the group with pre-eclampsia.
Conclusions: As with other forms of secondary hypertension, and unlike essential hypertension, the pathophysiology of pre-eclampsia is not associated with insulin resistance.