Evaluation And Correlation of Insulin Resistance And Lipid Profile In Normal Pregnancy And Preeclampsia

Abstract

Background: Preeclampsia syndrome is clinical spectrum of worsening disease with attenuated manifestations to cataclysmic deterioration, Life threatening for both mother and fetus. It affects 5-10% of all pregnancies & forms deadly triad with haemorrhage and infection being a direct cause of maternal mortality. Preeclampsia is associated with hyper insulinemia, increased insulin resistance which induces hypertriglyceridemia, endothelial dysfunction. It may lead to preeclampsia in genetically predisposed pregnant women. Association of high serum lipids with gestational protinuric hyerptension is highly suggestive of role for lipid profile analysis as diagnostic tool for preeclampisa. Aims & Objective: To evaluate and correlate fasting plasma insulin levels, insulin resistance and lipid profile in preeclampsia and normal pregnancy in ≥ 20 wks gestation. Material & methods: This is prospective observational study undertaken for one year on 40 pregnant women with preeclampsia and 25 normal pregnant women in tertiary care hospital in North India. Fasting plasma insulin levels, insulin resistance and lipid profile were evaluated in all 65 pregnant women in study and control group. Results: Mean age 26.±4.48 years, 25.0±2.79 years, mean period of gestation 32.38±2.53 wks, 29.48 ± 2.50 weeks in study & control group respectively were comparable. 52% patients in both the groups were primigravida. Mean fasting plasma insulin levels in study group i.e. 53.3 μIU/ml was significantly higher than, 16.35 μIU/ml in control group. Insulin resistance (HOMA IR index) in preeclampsia was 10.33, significantly high compared to 3.04 in normotensive pregnant women. Lipid profileserum cholesterol, triglycerides, HDL, LDL, VLDL were significantly raised in preeclampsia compared to control group. Conclusion: Highly significant increase in fasting plasma insulin levels, insulin resistance and lipid profile compared to normotensive pregnant females is a diagnostic tool for early diagnosis and management of preeclampsia step towards reducing maternal mortality and adverse fetal outcome.