Sella Zenita Sari, Ahsanudin Attamimi, Detty Siti Nurdiati
Department of Obstetrics and Gynecology
Faculty of Medicine Universitas Gadjah Mada/
Sardjito Hospital Yogyakarta
ABSTRACT
Background: Preeclampsia refers to a condition in which inflammation regulation system and endothelial function are abnormal. Adipose tissue expresses various secretory protein, some of which are leptin, TNFa and adiponectin. Adiponectin is a hormone produced by adipocytes and serving as anti-diabetic, anti–atherogenic, and anti-inflammatory adipokines. The decrease of adiponectin level in plasma is associated with obesity, insulin resistance, and DM type 2. Hypoadiponectin found in plasma results in insulin resistance, endothelial dysfunction and preeclampsia.
Objective: To examine the correlation between adiponectin level and insulin resistance towards severe preeclampsia.
Methods: A cross sectional study design was conducted in June 2014-August 2014 in dr. Sardjito General Hospital and affiliate hospitals. Sixty pregnant women included in this study consist of 30 pregnant women with severe preeclampsia and 30 women with normotensive pregnancy. Adiponectin was examined by Human adiponectin ELISA kit while insulin was examined by using Insulin ELISA kit in the Molecular Biology Laboratory, Faculty of Medicine Universitas Gadjah Mada. The analysis was performed by calculating p values and odds ratios with logistic regresion.
Result: The mean of adiponectin in pregnancy with preeclampsia is lower than that in normotensive pregnancy (9.86±3.54 ug/dl vs 18.30±4.98 ug/dl). Lower adiponectin increase the risk of severe preeclampsia with OR 0.394; CI 95% (0.212-0.734), p=0.003 (p<0.05). Mean of HOMA-IR is higher in severe preeclampsia than in normotensive pregnancy (2.38±1,01
mg/dl vs 1.82±0.47 mg/dl, p=0.000). Insulin resistance increase th risk of severe preeclampsia with OR 10.398; CI 95% (1.840-58.76), p= 0.024. There is a negative correlation between adiponectin level and insulin resistance (r = -0.547, p= 0.000).
Conclusion: Plasma adiponectin level in pregnancy with severe preeclampsia is lower than that of patients with normotensive pregnancy. Lower adiponectin has related to insulin resistance in severe preclampsia.
Keywords: preeclampsia, adiponectin, insulin resistance, HOMA-IR