Mechanism of Insulin Resistance in Normal Pregnancy

K. Hodson; C. Dalla Man; F. E. Smith; P. E. Thelwall; C. Cobelli; S. C. Robson; R. Taylor

doi:10.1055/s-0033-1337988

Hormone and Metabolic Research, Inhaltsverzeichnis

Horm Metab Res 2013; 45(08): 567-571
DOI: 10.1055/s-0033-1337988

Original Basic

Mechanism of Insulin Resistance in Normal Pregnancy

K. Hodson

¹Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK

²Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Foundation Trust, UK

,

C. Dalla Man

³Department of Information Engineering, University of Padua, Padua, Italy

,

F. E. Smith

¹Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK

⁴Newcastle Magnetic Resonance Centre, Newcastle University, Newcastle upon Tyne, UK

,

P. E. Thelwall

¹Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK

⁴Newcastle Magnetic Resonance Centre, Newcastle University, Newcastle upon Tyne, UK

,

C. Cobelli

³Department of Information Engineering, University of Padua, Padua, Italy

,

S. C. Robson

¹Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK

²Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Foundation Trust, UK

,

R. Taylor

¹Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK

²Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Foundation Trust, UK

⁴Newcastle Magnetic Resonance Centre, Newcastle University, Newcastle upon Tyne, UK

› Institutsangaben

Abstract

Normal pregnancy is associated with insulin resistance although the mechanism is not understood. Increased intramyocellular lipid is closely associated with the insulin resistance of type 2 diabetes and obesity, and the aim of this study was to determine whether this was so for the physiological insulin resistance of pregnancy. Eleven primiparous healthy pregnant women (age: 27–39 years, body mass index 24.0±3.1 kg/m²) and no personal or family history of diabetes underwent magnetic resonance studies to quantify intramyocellular lipid, plasma lipid fractions, and insulin sensitivity. The meal-related insulin sensitivity index was considerably lower in pregnancy (45.6±9.9 vs. 193.0±26.1; 10⁻⁴ dl/kg/min per pmol/l, p=0.0002). Fasting plasma triglyceride levels were elevated 3-fold during pregnancy (2.3±0.2 vs. 0.8±0.1 mmol/l, p<0.01) and the low-density density lipoprotein fraction, responsible for fatty acid delivery to muscle and other tissues, was 6-fold elevated (0.75±0.43 vs. 0.12±0.09 mmol/l; p=0.001). However, mean intramyocellular lipid concentrations of the soleus muscle were not different during pregnancy (20.0±2.3 vs. 19.1±3.2 mmol/l, p=0.64). The pregnancy effect on muscle insulin resistance is distinct from that underlying type 2 diabetes.

Key words

gestational diabetes - magnetic resonance spectroscopy - insulin resistance - intramyocellular lipid - pregnancy

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Referenzen

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