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Horm Metab Res 2013; 45(08): 567-571
DOI: 10.1055/s-0033-1337988
Original Basic
© Georg Thieme Verlag KG Stuttgart · New York

Mechanism of Insulin Resistance in Normal Pregnancy

Authors

  • K. Hodson

    1   Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
    2   Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Foundation Trust, UK

  • C. Dalla Man

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

  • F. E. Smith

    1   Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
    4   Newcastle Magnetic Resonance Centre, Newcastle University, Newcastle upon Tyne, UK

  • P. E. Thelwall

    1   Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
    4   Newcastle Magnetic Resonance Centre, Newcastle University, Newcastle upon Tyne, UK

  • C. Cobelli

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

  • S. C. Robson

    1   Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
    2   Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Foundation Trust, UK

  • R. Taylor

    1   Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
    2   Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Foundation Trust, UK
    4   Newcastle Magnetic Resonance Centre, Newcastle University, Newcastle upon Tyne, UK
Weitere Informationen

Publikationsverlauf

received 05. Dezember 2012

accepted 18. Februar 2013

Publikationsdatum:
02. April 2013 (online)

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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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