INSULIN RESISTANCE AND SUBCLINICAL INFLAMMATION IN GESTATIONAL DIABETES MELLITUS: ASSOCIATION WITH THE DEVELOPMENT OF PREECLAMPSIA
Keywords:
gestational diabetes mellitus, preeclampsia, insulin resistance, HOMA-IR, C-reactive protein, ferritin, body mass indexAbstract
Relevance: Gestational diabetes mellitus (GDM) is a well-established risk factor for preeclampsia. However, the predictive value of insulin resistance and subclinical inflammation markers in women with established GDM remains insufficiently investigated.
Purpose: To evaluate the association of insulin resistance and subclinical inflammation markers with the development of preeclampsia in pregnant women with GDM and to assess their predictive significance.
Materials and methods: A retrospective analysis was performed in a prospective cohort of 192 pregnant women with GDM identified during a multicenter screening study conducted in six regions of the Republic of Uzbekistan. Body mass index (BMI), insulin levels, HOMA-IR index, C-reactive protein (CRP), and ferritin levels were assessed. Correlation analysis, odds ratio estimation, and ROC analysis were performed.
Results: Preeclampsia developed in 10 of 192 women (5.2%). Women who subsequently developed preeclampsia had significantly higher BMI, HOMA-IR, CRP, and ferritin levels compared with women without preeclampsia (all p<0.05). CRP demonstrated the highest predictive performance (AUC=0.790). A combined model including HOMA-IR, CRP, and ferritin showed superior predictive accuracy with an AUC of 0.817.
Conclusion: The development of preeclampsia in women with GDM is associated with increased insulin resistance and subclinical inflammation. Combined assessment of HOMA-IR, CRP, and ferritin may improve risk stratification and facilitate early identification of women at high risk of preeclampsia.
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