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Insulin resistance and alterations in angiogenesis: additive insults that may lead to preeclampsia.

Publication ,  Journal Article
Thadhani, R; Ecker, JL; Mutter, WP; Wolf, M; Smirnakis, KV; Sukhatme, VP; Levine, RJ; Karumanchi, SA
Published in: Hypertension
May 2004

Altered angiogenesis and insulin resistance, which are intimately related at a molecular level, characterize preeclampsia. To test if an epidemiological interaction exists between these two alterations, we performed a nested case-control study of 28 women who developed preeclampsia and 57 contemporaneous controls. Serum samples at 12 weeks of gestation were measured for sex hormone binding globulin (SHBG; low levels correlate with insulin resistance) and placental growth factor (PlGF; a proangiogenic molecule). Compared with controls, women who developed preeclampsia had lower serum levels of SHBG (208+/-116 versus 256+/-101 nmol/L, P=0.05) and PlGF (16+/-14 versus 67+/-150 pg/mL, P<0.001), and in multivariable analysis, women with serum levels of PlGF < or =20 pg/mL had an increased risk of developing preeclampsia (odds ratio [OR] 7.6, 95% CI 1.4 to 38.4). Stratified by levels of serum SHBG (< or =175 versus >175 mg/dL), women with low levels of SHBG and PlGF had a 25.5-fold increased risk of developing preeclampsia (P=0.10), compared with 1.8 (P=0.38) among women with high levels of SHBG and low levels of PlGF. Formal testing for interaction (PlGFxSHBG) was significant (P=0.02). In a model with 3 (n-1) interaction terms (high PlGF and high SHBG, reference), the risk for developing preeclampsia was as follows: low PlGF and low SHBG, OR 15.1, 95% CI 1.7 to 134.9; high PlGF and low SHBG, OR 4.1, 95% CI 0.45 to 38.2; low PlGF and high SHBG, OR 8.7, 95% CI 1.2 to 60.3. Altered angiogenesis and insulin resistance are additive insults that lead to preeclampsia.

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Published In

Hypertension

DOI

EISSN

1524-4563

Publication Date

May 2004

Volume

43

Issue

5

Start / End Page

988 / 992

Location

United States

Related Subject Headings

  • Single-Blind Method
  • Sex Hormone-Binding Globulin
  • Sensitivity and Specificity
  • Prospective Studies
  • Pregnancy Trimester, First
  • Pregnancy Proteins
  • Pregnancy Outcome
  • Pregnancy
  • Pre-Eclampsia
  • Placenta Growth Factor
 

Citation

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Thadhani, R., Ecker, J. L., Mutter, W. P., Wolf, M., Smirnakis, K. V., Sukhatme, V. P., … Karumanchi, S. A. (2004). Insulin resistance and alterations in angiogenesis: additive insults that may lead to preeclampsia. Hypertension, 43(5), 988–992. https://doi.org/10.1161/01.HYP.0000124460.67539.1d
Thadhani, Ravi, Jeffrey L. Ecker, Walter P. Mutter, Myles Wolf, Karen V. Smirnakis, Vikas P. Sukhatme, Richard J. Levine, and S Ananth Karumanchi. “Insulin resistance and alterations in angiogenesis: additive insults that may lead to preeclampsia.Hypertension 43, no. 5 (May 2004): 988–92. https://doi.org/10.1161/01.HYP.0000124460.67539.1d.
Thadhani R, Ecker JL, Mutter WP, Wolf M, Smirnakis KV, Sukhatme VP, et al. Insulin resistance and alterations in angiogenesis: additive insults that may lead to preeclampsia. Hypertension. 2004 May;43(5):988–92.
Thadhani, Ravi, et al. “Insulin resistance and alterations in angiogenesis: additive insults that may lead to preeclampsia.Hypertension, vol. 43, no. 5, May 2004, pp. 988–92. Pubmed, doi:10.1161/01.HYP.0000124460.67539.1d.
Thadhani R, Ecker JL, Mutter WP, Wolf M, Smirnakis KV, Sukhatme VP, Levine RJ, Karumanchi SA. Insulin resistance and alterations in angiogenesis: additive insults that may lead to preeclampsia. Hypertension. 2004 May;43(5):988–992.

Published In

Hypertension

DOI

EISSN

1524-4563

Publication Date

May 2004

Volume

43

Issue

5

Start / End Page

988 / 992

Location

United States

Related Subject Headings

  • Single-Blind Method
  • Sex Hormone-Binding Globulin
  • Sensitivity and Specificity
  • Prospective Studies
  • Pregnancy Trimester, First
  • Pregnancy Proteins
  • Pregnancy Outcome
  • Pregnancy
  • Pre-Eclampsia
  • Placenta Growth Factor