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IGF-I, Osteocalcin, and Bone Change in Pregnant Normotensive and Pre-Eclamptic Women

Department of Epidemiology (M.S., J.G., M.J.), University of Michigan, Ann Arbor, Michigan 48109-2029; and University of Medicine and Dentistry of New Jersey (T.S., X.C.), Piscataway, New Jersey 08855-1179

Address all correspondence and requests for reprints to: MaryFran Sowers, Ph.D., Department of Epidemiology, University of Michigan, 109 South Observatory, Room 3073, SPH I, Ann Arbor, Michigan 48109-2029. E-Mail: mfsowers@umich.edu.

Abstract

Pre-eclampsia is a pregnancy disorder of uncertain etiology that affects 5–10% of all pregnancies, with symptoms typically presenting around or after 20 wk gestation. We hypothesized that IGF-I, osteocalcin, and bone loss would be different among women with pre-eclampsia compared with normotensive pregnant women.

There were 962 pregnant healthy women, aged 12–35, who were assessed at entry to care, at 28 wk, and at delivery for osteocalcin and IGF-I concentrations. Bone ultrasound was measured at entry to care and at 6 wk postpartum, whereas bone mineral density was measured by dual x-ray densitometry at delivery.

There were 64 women (6.7%) among the women being followed who developed pre-eclampsia. In women with pre-eclampsia, IGF-I concentrations were 74% greater in the third trimester compared with the first trimester, whereas there was little change in osteocalcin concentrations. In contrast, normotensive women had an average increase of 43% in IGF-I concentrations accompanied by a 63% decline in osteocalcin concentrations. In women with pre-eclampsia, IGF-I and osteocalcin concentrations were significantly correlated (r = 0.48 and 0.43) at both the first and third trimester time points, but only in the third trimester among normotensive women (r = 0.27). The bone change difference between the two groups was not statistically significant.

Women with pre-eclampsia appear to have an exaggerated IGF-I responsiveness compared with women who are normotensive; however, the strong correlation between IGF-I and osteocalcin in women with pre-eclampsia suggests that the IGF-I is able to retain its role as a local regulator of bone remodeling, as indicated by the osteocalcin concentrations.

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