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Mechanism of Insulin Resistance in Normal Pregnancy

Lookup NU author(s): Dr Kenneth Hodson, Dr Fiona Smith, Professor Peter Thelwall, Professor Stephen Robson, Professor Roy Taylor

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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/m(2)) 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.


Publication metadata

Author(s): Hodson K, Man CD, Smith FE, Thelwall PE, Cobelli C, Robson SC, Taylor R

Publication type: Article

Publication status: Published

Journal: HORMONE AND METABOLIC RESEARCH

Year: 2013

Volume: 45

Issue: 8

Pages: 567-571

Print publication date: 01/08/2013

ISSN (print): 0018-5043

ISSN (electronic):

Publisher: GEORG THIEME VERLAG KG

DOI: 10.1055/s-0033-1337988


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