ESPE Abstracts

Background: Maternal preeclampsia has been associated with increased risk for later metabolic disturbances in the offspring.

Objective: We investigated whether maternal preeclampsia influences insulin sensitivity (IS) and low-grade inflammation in young adulthood and whether unfavourable metabolic features in childhood predict low IS at 20 years of age.

Methods: Forty-seven 20-year-old subjects (25 women) born from preeclamptic pregnancies (PRE) and 55 controls born from non-preeclamptic pregnancies (non-PRE, 36 women) were studied. Previously, 38 of these PREs and 46 of the non-PREs had been studied at the age of 12 years. Body mass index (BMI), BMI adjusted for sex and adult height (BMIadj) (at age 12 years), and waist-to-height-ratio (WHtR) were calculated. Fasting serum insulin, IGFBP-2, high-molecular-weight adiponectin (HMW-adipo), triglycerides, HDL cholesterol, high-sensitivity CRP (hs-CRP), interleukin-1 receptor antagonist (IL-1Ra) and blood glucose were measured. IS was estimated by Quantitative Insulin Sensitivity Check Index (QUICKI).

Results: The PRE subjects had lower HMW-adipo (1.69 vs. 2.24 mg/ml, P=0.027) and HDL cholesterol (1.42 vs. 1.56 mmol/l, P=0.024) concentrations than the controls at 20 years of age. The means of other measured parameters had no difference between the PRE and non-PRE groups (P>0.05 for all). The PREs in the lowest QUICKI tertile (n=16) had lower IGFBP-2 (124.9 vs. 255.1 ng/ml, P<0.001), higher hs-CRP (3.82 vs. 1.71 mg/l, P=0.004) and IL-1Ra (544.7 vs. 250.3 pg/ml, P<0.001) concentrations and WHtR (0.52 vs. 0.46, P=0.014) than the PREs with higher IS (n=31). In the non-PREs, those in the lowest QUICKI tertile (n=18) had higher BMI (26.7 vs. 22.4 kg/m², P=0.011) than those with higher IS (n=37), otherwise the differences between the two QUICKI groups in the corresponding parameters were similar as in the PREs. In the controls, the difference in IGFBP-2 and hs-CRP concentrations was dependent on BMI. In the whole study population and in the non-PREs, higher BMIadj at 12 years predicted low QUICKI at 20 years (n=84, β=-0.374, P=0.025 and n=46, β=-0.750, P=0.003, respectively). In the PREs, none of the parameters measured at 12 years predicted low QUICKI at 20 years of age.

Conclusion: Young adults born from preeclamptic pregnancies did not have reduced IS compared with controls. At 20 years of age, those with lowest IS had higher low-grade inflammation markers and lower IGFBP-2 concentrations; in the PRE group all differences were BMI-independent. In those exposed to maternal preeclampsia, other factors than childhood BMI may affect reduced IS in young adulthood.