Relationship of insulin resistance with recurrent pregnancy loss

Abstract

Background: The recurrent pregnancy loss (RPL) is defined as two and more failed pregnancies as documented by ultrasound and histopathological examination and suggested some assessment after each loss with a thorough evaluation after three or more losses. RPL is one of the most frustrating and difficult areas in reproductive medicine because the aetiology is often unknown and there are few evidence based diagnostic and treatment strategies.Methods: 150 Non pregnant females were taken as both cases and controls in the study. All the pregnancy losses were documented by ultrasound or histological examination after uterine curettage. The control group consisted of women with no RPL with at least one live birth. These two groups were matched on the basis of age and BMI. All the women underwent following examinations, viz. Hysterosalpingography, karyotype of both partners, serum TSH, FT4, prolactin and antibodies for APLA. In addition blood sample were taken for fasting serum glucose and serum insulin level later insulin resistance was calculate using three parameters Fasting insulin > 20IU/ml. Diagnostic of Insulin Resistance. (2) Fasting glucose / Fasting insulin. A ratio of < 4.5 being diagnostic of insulin resistance. (3) HOMA IR. FG (mg/dl) x FPI (IU/ml) FG (mmol/l) x FPI (IU/ml)------------------------------------ OR ----------------------------------- 405 22.5Where 1 mmol/l = 18mg/dl, A value of > 4.5 being diagnostic of insulin resistance.Results: 150 patients were enrolled in this study among which 75 were selected as cases and 75 as controls after fulfilling inclusion and exclusion criteria with mean age cases group was28.4+2.37 years and 29.1+2.70 years in control group mean miscarriage rate in study group was 3.17+83 and control group with 0.35+0.48 with statistically significant difference. Mean fasting glucose (96.5+ 7.86) mg/dl, Fasting Insulin (14.1±5.91) IU/ml. Mean Glucose Insulin ratio (8.1±3.39), HOMA-IR (3.4 ±1.51) in the study group and in control group mean fasting glucose was (87.1+11.49) mg/dl, Fasting Insulin (6.9 ± 4.99) IU/ml. Mean Glucose Insulin ratio (17.8 ±11.44), HOMA-IR (1.5 ±1.27) respectively with statistically significant difference.Conclusions: In women with recurrent pregnancy loss fasting insulin and insulin resistance are higher than those in women without spontaneous abortion. The most sensitive parameter for calculating insulin resistance was found to be fasting insulin followed by HOMA – IR and followed by fasting glucose/fasting insulin ratio. It is therefore important to recommend a fasting insulin and fasting glucose level while evaluating a case of recurrent pregnancy loss to assess for insulin resistance.

High insulin resistance in saudi women with unexplained recurrent pregnancy loss: A case–control study

“…These findings are in contrast to those of other studies where the mean FG in the study group was higher. [ 26 27 ] In the current study, the mean FI was significantly higher in the study group than the control group, which is similar to the findings of previous studies. [ 26 27 28 29 ]…”

“…The patients in the study group were significantly older and had a higher BMI than those in the control group, which was not the case in other studies. [ 26 27 ] While these baseline differences between the two groups could itself be a contributing factor to higher insulin level and IR, the logistic regression analysis, which included both these factors as confounders, found IR to be an independent predictor of unexplained RPL. Notably, the mean FG was marginally higher in the control group than the study group.…”

Occurrence of Insulin Resistance with Recurrent Pregnancy Loss of Unknown Etiology in North Indian Hospital-based Women Population: A Pilot Study

“…In our study, there was a statistically significant difference in the fasting glucose levels (83.82 ± 7.51 mg/dL, 75.26 ± 6.43 mg/dL) and fasting serum insulin levels (10.13 ± 6.4 µIU/mL, 5.73 ± 3.45 µIU/mL) in case vs control groups. Similar findings have been reported by Wani et al, 12 Celik Nazan et al, 13 KA Wahba et al, 14 and Wang Y Zhao et al 15 The HOMA-IR value in our study was 2.07 ± 1.27 in the cases group and 1.02 ± 1.07 in control group which is in congruence with the findings of the study done by Corrina-Alina et al 16 where mean HOMA-IR in the study group was 2.98 and in the control group was 1.69 with a significant p value <0.001.…”

A Short Review on Cellular Structure Design and Selective Laser Melting using Bio-compatible Ti6Al4V Material

“…As described early, it is very important to manufacture implants with high accuracy and precision. The implant has been manufactured using various AM methods such as SLM, Electron Beam Melting (EBM), In these methods, the smallest printable size is 50-200μm which is too small to be used for some biomedical scaffold or certain producing big in size on biomedical implant application [2].…”