Blood pressure and insulin resistance in non‑diabetic and normotensive pregnant women

Physiological and biochemical changes during normal pregnancy may precipitate a state of insulin resistance (IR) without disrupting the body's physiology. The present study aimed to investigate the association between the indices of insulin sensitivity and blood pressure among normotensive and euglycemic pregnant women. The present cross‑sectional study was conducted between February and December, 2021. It comprised 133 normal pregnant women who were non‑diabetic and had normal blood pressure. The oral glucose tolerance test and fasting insulin levels were assessed, and the indices of insulin sensitivity and β‑cell function were computed between the 24th and 28th weeks of gestation. A multivariate linear regression analysis was conducted to investigate the factors affecting systolic and diastolic blood pressure levels, including the indices of insulin sensitivity, β‑cell function and others. Univariate linear analysis revealed that fasting insulin levels (β=0.95, P=0.027), the quantitative insulin sensitivity check index (QUICKI; β=‑24.39, P=0.012) and diastolic blood pressure (β=0.76, P<0.001) were associated with systolic blood pressure. Of note, parity (β=0.83, P=0.031), fasting insulin levels (β=0.63, P=0.010), homeostasis model assessment of IR (HOMA‑IR; β=3.19, P=0.013) and QUICKI (β=‑11.97, P=0.029) were the factors that were associated with diastolic blood pressure. In the multivariate linear regression analysis, neither fasting insulin, nor QUICKI were found to be associated with systolic blood pressure. Fasting insulin levels (β=0.48; P=0.040), HOMA‑IR (β=2.51; P=0.043) were associated with diastolic blood pressure. On the whole, in the present study, fasting insulin levels and HOMA‑IR were associated with diastolic blood pressure levels without the emergence of high blood pressure readings or gestational diabetes. Further studies with a longitudinal approach are warranted to further identify associations with IR.