Increased Intramyocellular Lipid Concentration Identifies Impaired Glucose Metabolism in Women With Previous Gestational Diabetes
Increased Intramyocellular Lipid Concentration Identifies Impaired Glucose Metabolism in Women With Previous Gestational Diabetes Alexandra Kautzky-Willer 1 , Martin Krssak 1 , Christine Winzer 1 , Giovanni Pacini 2 , Andrea Tura 2 , Serdar Farhan 1 , Oswald Wagner 3 , Georg Brabant 4 , Rüdiger Horn...
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| Veröffentlicht in: | Diabetes (New York, N.Y.) N.Y.), 2003-02, Vol.52 (2), p.244-251 |
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| creator | KAUTZKY-WILLER, Alexandra KRSSAK, Martin SCHNEIDER, Barbara WALDHÄUSL, Werner RODEN, Michael WINZER, Christine PACINI, Giovanni TURA, Andrea FARHAN, Serdar WAGNER, Oswald BRABANT, Georg HORN, Rüdiger STINGL, Harald |
| description | Increased Intramyocellular Lipid Concentration Identifies Impaired Glucose Metabolism in Women With Previous Gestational Diabetes
Alexandra Kautzky-Willer 1 ,
Martin Krssak 1 ,
Christine Winzer 1 ,
Giovanni Pacini 2 ,
Andrea Tura 2 ,
Serdar Farhan 1 ,
Oswald Wagner 3 ,
Georg Brabant 4 ,
Rüdiger Horn 4 ,
Harald Stingl 1 ,
Barbara Schneider 5 ,
Werner Waldhäusl 1 and
Michael Roden 1
1 Department of Internal Medicine III, Division of Endocrinology and Metabolism, University of Vienna, Vienna, Austria
2 Metabolic Unit, Institute of Biomedical Engineering, National Research Council (ISIB-CNR), Padova, Italy
3 Institute for Medical Laboratory Diagnostics, University of Vienna, Vienna, Austria
4 Division of Endocrinology, University of Hannover, Hannover, Germany
5 Institute of Biostatistics, University of Vienna, Vienna, Austria
Abstract
Women with previous gestational diabetes (pGDM) are frequently insulin-resistant, which could relate to intramyocellular lipid
content (IMCL). IMCL were measured with 1 H nuclear magnetic resonance spectroscopy in soleus (IMCL-S) and tibialis-anterior muscles (IMCL-T) of 39 pGDM (32 ± 2 years,
waist-to-hip ratio 0.81 ± 0.01) and 22 women with normal glucose tolerance (NGT; 31 ± 1 years, 0.76 ± 0.02) at 4–6 months
after delivery. Body fat mass (BFM) was assessed from bioimpedance analysis, insulin sensitivity index (S I ), and glucose effectiveness (S G ) from insulin-modified frequently sampled glucose tolerance tests. pGDM exhibited 45% increased BFM, 35% reduced S I and S G ( P < 0.05), and 40% ( P < 0.05) and 55% ( P < 0.005) higher IMCL-S and IMCL-T, respectively. IMCL related to body fat (BFM P < 0.005, leptin P < 0.03), but only IMCL-T correlated ( P < 0.03) with S I and glucose tolerance index independent of BMI. Insulin-resistant pGDM ( n = 17) had higher IMCL-S (+66%) and IMCL-T (+86%) than NGT and insulin-sensitive pGDM (+28%). IMCL were also higher ( P < 0.005, P = 0.05) in insulin-sensitive pGDM requiring insulin treatment during pregnancy and inversely related to the gestational week
of GDM diagnosis. Thus, IMCL-T reflects insulin sensitivity, whereas IMCL-S relates to obesity. IMCL could serve as an additional
parameter of increased diabetes risk because it identifies insulin-resistant pGDM and those who were diagnosed earlier and/or
required insulin during pregnancy.
Footnotes
Address correspondence and reprint requests to Michael Roden, MD, Division of Endocrinology and Metabolism, Department of
Internal Medicine |
| doi_str_mv | 10.2337/diabetes.52.2.244 |
| format | Article |
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Alexandra Kautzky-Willer 1 ,
Martin Krssak 1 ,
Christine Winzer 1 ,
Giovanni Pacini 2 ,
Andrea Tura 2 ,
Serdar Farhan 1 ,
Oswald Wagner 3 ,
Georg Brabant 4 ,
Rüdiger Horn 4 ,
Harald Stingl 1 ,
Barbara Schneider 5 ,
Werner Waldhäusl 1 and
Michael Roden 1
1 Department of Internal Medicine III, Division of Endocrinology and Metabolism, University of Vienna, Vienna, Austria
2 Metabolic Unit, Institute of Biomedical Engineering, National Research Council (ISIB-CNR), Padova, Italy
3 Institute for Medical Laboratory Diagnostics, University of Vienna, Vienna, Austria
4 Division of Endocrinology, University of Hannover, Hannover, Germany
5 Institute of Biostatistics, University of Vienna, Vienna, Austria
Abstract
Women with previous gestational diabetes (pGDM) are frequently insulin-resistant, which could relate to intramyocellular lipid
content (IMCL). IMCL were measured with 1 H nuclear magnetic resonance spectroscopy in soleus (IMCL-S) and tibialis-anterior muscles (IMCL-T) of 39 pGDM (32 ± 2 years,
waist-to-hip ratio 0.81 ± 0.01) and 22 women with normal glucose tolerance (NGT; 31 ± 1 years, 0.76 ± 0.02) at 4–6 months
after delivery. Body fat mass (BFM) was assessed from bioimpedance analysis, insulin sensitivity index (S I ), and glucose effectiveness (S G ) from insulin-modified frequently sampled glucose tolerance tests. pGDM exhibited 45% increased BFM, 35% reduced S I and S G ( P < 0.05), and 40% ( P < 0.05) and 55% ( P < 0.005) higher IMCL-S and IMCL-T, respectively. IMCL related to body fat (BFM P < 0.005, leptin P < 0.03), but only IMCL-T correlated ( P < 0.03) with S I and glucose tolerance index independent of BMI. Insulin-resistant pGDM ( n = 17) had higher IMCL-S (+66%) and IMCL-T (+86%) than NGT and insulin-sensitive pGDM (+28%). IMCL were also higher ( P < 0.005, P = 0.05) in insulin-sensitive pGDM requiring insulin treatment during pregnancy and inversely related to the gestational week
of GDM diagnosis. Thus, IMCL-T reflects insulin sensitivity, whereas IMCL-S relates to obesity. IMCL could serve as an additional
parameter of increased diabetes risk because it identifies insulin-resistant pGDM and those who were diagnosed earlier and/or
required insulin during pregnancy.
Footnotes
Address correspondence and reprint requests to Michael Roden, MD, Division of Endocrinology and Metabolism, Department of
Internal Medicine III, University of Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria. E-mail: michael.roden{at}akh-wien.ac.at .
Received for publication 25 June 2002 and accepted in revised form 16 October 2002.
AIRg 3–10, acute insulin response 3–10 min after glucose ingestion; BFM, body fat mass; BW, body weight; FFM, fat-free mass;
GDM, gestational diabetes mellitus; IMCL, intramyocellular lipid content; IMCL-S, IMCL of soleus muscle; IMCL-T, IMCL of tibialis
anterior; NGT, normal glucose tolerance; NMRS, nuclear magnetic resonance spectroscopy; OGIS, insulin sensitivity parameter;
OGTT, oral glucose tolerance test; pGDM, previous gestational diabetes mellitus; S I , insulin sensitivity index.
DIABETES]]></description><identifier>ISSN: 0012-1797</identifier><identifier>EISSN: 1939-327X</identifier><identifier>DOI: 10.2337/diabetes.52.2.244</identifier><identifier>PMID: 12540593</identifier><identifier>CODEN: DIAEAZ</identifier><language>eng</language><publisher>Alexandria, VA: American Diabetes Association</publisher><subject>Adult ; Biological and medical sciences ; Blood Glucose - metabolism ; Blood pressure ; Body Constitution ; Body fat ; Body Mass Index ; Diabetes in pregnancy ; Diabetes, Gestational - blood ; Diabetes, Gestational - physiopathology ; Diabetes. Impaired glucose tolerance ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Female ; Gestational diabetes ; Glucose ; Glucose Intolerance - blood ; Glucose metabolism ; Glucose Tolerance Test ; Humans ; Insulin resistance ; Insulin Resistance - physiology ; Leptin - blood ; Lipid Metabolism ; Lipids ; Lipids - blood ; Magnetic Resonance Imaging ; Measurement ; Medical sciences ; Metabolism ; Muscle, Skeletal - metabolism ; NMR ; Nuclear magnetic resonance ; Obesity ; Physiological aspects ; Pregnancy ; Receptors, Cell Surface - metabolism ; Receptors, Leptin ; Regression Analysis ; Spectrum analysis</subject><ispartof>Diabetes (New York, N.Y.), 2003-02, Vol.52 (2), p.244-251</ispartof><rights>2003 INIST-CNRS</rights><rights>COPYRIGHT 2003 American Diabetes Association</rights><rights>Copyright American Diabetes Association Feb 2003</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c577t-204a20f8f2baae93f3ae05b354f447ff351c84834bf724f92d991604ad6b25fa3</citedby><cites>FETCH-LOGICAL-c577t-204a20f8f2baae93f3ae05b354f447ff351c84834bf724f92d991604ad6b25fa3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14523256$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12540593$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>KAUTZKY-WILLER, Alexandra</creatorcontrib><creatorcontrib>KRSSAK, Martin</creatorcontrib><creatorcontrib>SCHNEIDER, Barbara</creatorcontrib><creatorcontrib>WALDHÄUSL, Werner</creatorcontrib><creatorcontrib>RODEN, Michael</creatorcontrib><creatorcontrib>WINZER, Christine</creatorcontrib><creatorcontrib>PACINI, Giovanni</creatorcontrib><creatorcontrib>TURA, Andrea</creatorcontrib><creatorcontrib>FARHAN, Serdar</creatorcontrib><creatorcontrib>WAGNER, Oswald</creatorcontrib><creatorcontrib>BRABANT, Georg</creatorcontrib><creatorcontrib>HORN, Rüdiger</creatorcontrib><creatorcontrib>STINGL, Harald</creatorcontrib><title>Increased Intramyocellular Lipid Concentration Identifies Impaired Glucose Metabolism in Women With Previous Gestational Diabetes</title><title>Diabetes (New York, N.Y.)</title><addtitle>Diabetes</addtitle><description><![CDATA[Increased Intramyocellular Lipid Concentration Identifies Impaired Glucose Metabolism in Women With Previous Gestational Diabetes
Alexandra Kautzky-Willer 1 ,
Martin Krssak 1 ,
Christine Winzer 1 ,
Giovanni Pacini 2 ,
Andrea Tura 2 ,
Serdar Farhan 1 ,
Oswald Wagner 3 ,
Georg Brabant 4 ,
Rüdiger Horn 4 ,
Harald Stingl 1 ,
Barbara Schneider 5 ,
Werner Waldhäusl 1 and
Michael Roden 1
1 Department of Internal Medicine III, Division of Endocrinology and Metabolism, University of Vienna, Vienna, Austria
2 Metabolic Unit, Institute of Biomedical Engineering, National Research Council (ISIB-CNR), Padova, Italy
3 Institute for Medical Laboratory Diagnostics, University of Vienna, Vienna, Austria
4 Division of Endocrinology, University of Hannover, Hannover, Germany
5 Institute of Biostatistics, University of Vienna, Vienna, Austria
Abstract
Women with previous gestational diabetes (pGDM) are frequently insulin-resistant, which could relate to intramyocellular lipid
content (IMCL). IMCL were measured with 1 H nuclear magnetic resonance spectroscopy in soleus (IMCL-S) and tibialis-anterior muscles (IMCL-T) of 39 pGDM (32 ± 2 years,
waist-to-hip ratio 0.81 ± 0.01) and 22 women with normal glucose tolerance (NGT; 31 ± 1 years, 0.76 ± 0.02) at 4–6 months
after delivery. Body fat mass (BFM) was assessed from bioimpedance analysis, insulin sensitivity index (S I ), and glucose effectiveness (S G ) from insulin-modified frequently sampled glucose tolerance tests. pGDM exhibited 45% increased BFM, 35% reduced S I and S G ( P < 0.05), and 40% ( P < 0.05) and 55% ( P < 0.005) higher IMCL-S and IMCL-T, respectively. IMCL related to body fat (BFM P < 0.005, leptin P < 0.03), but only IMCL-T correlated ( P < 0.03) with S I and glucose tolerance index independent of BMI. Insulin-resistant pGDM ( n = 17) had higher IMCL-S (+66%) and IMCL-T (+86%) than NGT and insulin-sensitive pGDM (+28%). IMCL were also higher ( P < 0.005, P = 0.05) in insulin-sensitive pGDM requiring insulin treatment during pregnancy and inversely related to the gestational week
of GDM diagnosis. Thus, IMCL-T reflects insulin sensitivity, whereas IMCL-S relates to obesity. IMCL could serve as an additional
parameter of increased diabetes risk because it identifies insulin-resistant pGDM and those who were diagnosed earlier and/or
required insulin during pregnancy.
Footnotes
Address correspondence and reprint requests to Michael Roden, MD, Division of Endocrinology and Metabolism, Department of
Internal Medicine III, University of Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria. E-mail: michael.roden{at}akh-wien.ac.at .
Received for publication 25 June 2002 and accepted in revised form 16 October 2002.
AIRg 3–10, acute insulin response 3–10 min after glucose ingestion; BFM, body fat mass; BW, body weight; FFM, fat-free mass;
GDM, gestational diabetes mellitus; IMCL, intramyocellular lipid content; IMCL-S, IMCL of soleus muscle; IMCL-T, IMCL of tibialis
anterior; NGT, normal glucose tolerance; NMRS, nuclear magnetic resonance spectroscopy; OGIS, insulin sensitivity parameter;
OGTT, oral glucose tolerance test; pGDM, previous gestational diabetes mellitus; S I , insulin sensitivity index.
DIABETES]]></description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Blood Glucose - metabolism</subject><subject>Blood pressure</subject><subject>Body Constitution</subject><subject>Body fat</subject><subject>Body Mass Index</subject><subject>Diabetes in pregnancy</subject><subject>Diabetes, Gestational - blood</subject><subject>Diabetes, Gestational - physiopathology</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Female</subject><subject>Gestational diabetes</subject><subject>Glucose</subject><subject>Glucose Intolerance - blood</subject><subject>Glucose metabolism</subject><subject>Glucose Tolerance Test</subject><subject>Humans</subject><subject>Insulin resistance</subject><subject>Insulin Resistance - physiology</subject><subject>Leptin - blood</subject><subject>Lipid Metabolism</subject><subject>Lipids</subject><subject>Lipids - blood</subject><subject>Magnetic Resonance Imaging</subject><subject>Measurement</subject><subject>Medical sciences</subject><subject>Metabolism</subject><subject>Muscle, Skeletal - metabolism</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Obesity</subject><subject>Physiological aspects</subject><subject>Pregnancy</subject><subject>Receptors, Cell Surface - metabolism</subject><subject>Receptors, Leptin</subject><subject>Regression Analysis</subject><subject>Spectrum analysis</subject><issn>0012-1797</issn><issn>1939-327X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNpt0l9v0zAQAPAIgVgZfABeUIQEQmgp_hsnj1OBUqloPIDgzXKcc-vJiTs7Ydsj3xyXFlWF6iQnSn5nn0-XZc8xmhJKxbvWqgYGiFNOpikYe5BNcE3rghLx42E2QQiTAotanGVPYrxGCJUpHmdnmHCGeE0n2a9FrwOoCG2-6IegunuvwbnRqZAv7ca2-cz3Gra_Buv7fNGmd2ssxHzRbZQNKXHuRu0j5J9hUI13Nna57fPvvoO02mGdfwnw0_ox5nOIw599lMvf74t_mj0yykV4tn-eZ98-fvg6-1Qsr-aL2eWy0FyIoSCIKYJMZUijFNTUUAWIN5Qzw5gwhnKsK1ZR1hhBmKlJW9e4TElt2RBuFD3PXu_23QR_M6ZCZGfj9q6qh1SbFKQWlIsqwZf_wGs_hlRylASXrEKlwAld7NBKOZC2Nz51SK-gh6Cc78HY9PmyFpWghKLEixM8RQud1af8myOfyAB3w0qNMcpqvjyiF6eo9s7BCmTq4ezqiOMd18HHGMDITbCdCvcSI7mdKvl3qiQnMgVjKefFviNj00F7yNiPUQKv9kBFrZwJqtc2HhzjhBJeJvd259Z2tb5Nw3M47P9TfwO4CuXE</recordid><startdate>20030201</startdate><enddate>20030201</enddate><creator>KAUTZKY-WILLER, Alexandra</creator><creator>KRSSAK, Martin</creator><creator>SCHNEIDER, Barbara</creator><creator>WALDHÄUSL, Werner</creator><creator>RODEN, Michael</creator><creator>WINZER, Christine</creator><creator>PACINI, Giovanni</creator><creator>TURA, Andrea</creator><creator>FARHAN, Serdar</creator><creator>WAGNER, Oswald</creator><creator>BRABANT, Georg</creator><creator>HORN, Rüdiger</creator><creator>STINGL, Harald</creator><general>American Diabetes Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>8GL</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M2P</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>20030201</creationdate><title>Increased Intramyocellular Lipid Concentration Identifies Impaired Glucose Metabolism in Women With Previous Gestational Diabetes</title><author>KAUTZKY-WILLER, Alexandra ; KRSSAK, Martin ; SCHNEIDER, Barbara ; WALDHÄUSL, Werner ; RODEN, Michael ; WINZER, Christine ; PACINI, Giovanni ; TURA, Andrea ; FARHAN, Serdar ; WAGNER, Oswald ; BRABANT, Georg ; HORN, Rüdiger ; STINGL, Harald</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c577t-204a20f8f2baae93f3ae05b354f447ff351c84834bf724f92d991604ad6b25fa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Blood Glucose - metabolism</topic><topic>Blood pressure</topic><topic>Body Constitution</topic><topic>Body fat</topic><topic>Body Mass Index</topic><topic>Diabetes in pregnancy</topic><topic>Diabetes, Gestational - blood</topic><topic>Diabetes, Gestational - physiopathology</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>Female</topic><topic>Gestational diabetes</topic><topic>Glucose</topic><topic>Glucose Intolerance - blood</topic><topic>Glucose metabolism</topic><topic>Glucose Tolerance Test</topic><topic>Humans</topic><topic>Insulin resistance</topic><topic>Insulin Resistance - physiology</topic><topic>Leptin - blood</topic><topic>Lipid Metabolism</topic><topic>Lipids</topic><topic>Lipids - blood</topic><topic>Magnetic Resonance Imaging</topic><topic>Measurement</topic><topic>Medical sciences</topic><topic>Metabolism</topic><topic>Muscle, Skeletal - metabolism</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Obesity</topic><topic>Physiological aspects</topic><topic>Pregnancy</topic><topic>Receptors, Cell Surface - metabolism</topic><topic>Receptors, Leptin</topic><topic>Regression Analysis</topic><topic>Spectrum analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>KAUTZKY-WILLER, Alexandra</creatorcontrib><creatorcontrib>KRSSAK, Martin</creatorcontrib><creatorcontrib>SCHNEIDER, Barbara</creatorcontrib><creatorcontrib>WALDHÄUSL, Werner</creatorcontrib><creatorcontrib>RODEN, Michael</creatorcontrib><creatorcontrib>WINZER, Christine</creatorcontrib><creatorcontrib>PACINI, Giovanni</creatorcontrib><creatorcontrib>TURA, Andrea</creatorcontrib><creatorcontrib>FARHAN, Serdar</creatorcontrib><creatorcontrib>WAGNER, Oswald</creatorcontrib><creatorcontrib>BRABANT, Georg</creatorcontrib><creatorcontrib>HORN, Rüdiger</creatorcontrib><creatorcontrib>STINGL, Harald</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: High School</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetes (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>KAUTZKY-WILLER, Alexandra</au><au>KRSSAK, Martin</au><au>SCHNEIDER, Barbara</au><au>WALDHÄUSL, Werner</au><au>RODEN, Michael</au><au>WINZER, Christine</au><au>PACINI, Giovanni</au><au>TURA, Andrea</au><au>FARHAN, Serdar</au><au>WAGNER, Oswald</au><au>BRABANT, Georg</au><au>HORN, Rüdiger</au><au>STINGL, Harald</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Increased Intramyocellular Lipid Concentration Identifies Impaired Glucose Metabolism in Women With Previous Gestational Diabetes</atitle><jtitle>Diabetes (New York, N.Y.)</jtitle><addtitle>Diabetes</addtitle><date>2003-02-01</date><risdate>2003</risdate><volume>52</volume><issue>2</issue><spage>244</spage><epage>251</epage><pages>244-251</pages><issn>0012-1797</issn><eissn>1939-327X</eissn><coden>DIAEAZ</coden><abstract><![CDATA[Increased Intramyocellular Lipid Concentration Identifies Impaired Glucose Metabolism in Women With Previous Gestational Diabetes
Alexandra Kautzky-Willer 1 ,
Martin Krssak 1 ,
Christine Winzer 1 ,
Giovanni Pacini 2 ,
Andrea Tura 2 ,
Serdar Farhan 1 ,
Oswald Wagner 3 ,
Georg Brabant 4 ,
Rüdiger Horn 4 ,
Harald Stingl 1 ,
Barbara Schneider 5 ,
Werner Waldhäusl 1 and
Michael Roden 1
1 Department of Internal Medicine III, Division of Endocrinology and Metabolism, University of Vienna, Vienna, Austria
2 Metabolic Unit, Institute of Biomedical Engineering, National Research Council (ISIB-CNR), Padova, Italy
3 Institute for Medical Laboratory Diagnostics, University of Vienna, Vienna, Austria
4 Division of Endocrinology, University of Hannover, Hannover, Germany
5 Institute of Biostatistics, University of Vienna, Vienna, Austria
Abstract
Women with previous gestational diabetes (pGDM) are frequently insulin-resistant, which could relate to intramyocellular lipid
content (IMCL). IMCL were measured with 1 H nuclear magnetic resonance spectroscopy in soleus (IMCL-S) and tibialis-anterior muscles (IMCL-T) of 39 pGDM (32 ± 2 years,
waist-to-hip ratio 0.81 ± 0.01) and 22 women with normal glucose tolerance (NGT; 31 ± 1 years, 0.76 ± 0.02) at 4–6 months
after delivery. Body fat mass (BFM) was assessed from bioimpedance analysis, insulin sensitivity index (S I ), and glucose effectiveness (S G ) from insulin-modified frequently sampled glucose tolerance tests. pGDM exhibited 45% increased BFM, 35% reduced S I and S G ( P < 0.05), and 40% ( P < 0.05) and 55% ( P < 0.005) higher IMCL-S and IMCL-T, respectively. IMCL related to body fat (BFM P < 0.005, leptin P < 0.03), but only IMCL-T correlated ( P < 0.03) with S I and glucose tolerance index independent of BMI. Insulin-resistant pGDM ( n = 17) had higher IMCL-S (+66%) and IMCL-T (+86%) than NGT and insulin-sensitive pGDM (+28%). IMCL were also higher ( P < 0.005, P = 0.05) in insulin-sensitive pGDM requiring insulin treatment during pregnancy and inversely related to the gestational week
of GDM diagnosis. Thus, IMCL-T reflects insulin sensitivity, whereas IMCL-S relates to obesity. IMCL could serve as an additional
parameter of increased diabetes risk because it identifies insulin-resistant pGDM and those who were diagnosed earlier and/or
required insulin during pregnancy.
Footnotes
Address correspondence and reprint requests to Michael Roden, MD, Division of Endocrinology and Metabolism, Department of
Internal Medicine III, University of Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria. E-mail: michael.roden{at}akh-wien.ac.at .
Received for publication 25 June 2002 and accepted in revised form 16 October 2002.
AIRg 3–10, acute insulin response 3–10 min after glucose ingestion; BFM, body fat mass; BW, body weight; FFM, fat-free mass;
GDM, gestational diabetes mellitus; IMCL, intramyocellular lipid content; IMCL-S, IMCL of soleus muscle; IMCL-T, IMCL of tibialis
anterior; NGT, normal glucose tolerance; NMRS, nuclear magnetic resonance spectroscopy; OGIS, insulin sensitivity parameter;
OGTT, oral glucose tolerance test; pGDM, previous gestational diabetes mellitus; S I , insulin sensitivity index.
DIABETES]]></abstract><cop>Alexandria, VA</cop><pub>American Diabetes Association</pub><pmid>12540593</pmid><doi>10.2337/diabetes.52.2.244</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0012-1797 |
| ispartof | Diabetes (New York, N.Y.), 2003-02, Vol.52 (2), p.244-251 |
| issn | 0012-1797 1939-327X |
| language | eng |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Adult Biological and medical sciences Blood Glucose - metabolism Blood pressure Body Constitution Body fat Body Mass Index Diabetes in pregnancy Diabetes, Gestational - blood Diabetes, Gestational - physiopathology Diabetes. Impaired glucose tolerance Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Female Gestational diabetes Glucose Glucose Intolerance - blood Glucose metabolism Glucose Tolerance Test Humans Insulin resistance Insulin Resistance - physiology Leptin - blood Lipid Metabolism Lipids Lipids - blood Magnetic Resonance Imaging Measurement Medical sciences Metabolism Muscle, Skeletal - metabolism NMR Nuclear magnetic resonance Obesity Physiological aspects Pregnancy Receptors, Cell Surface - metabolism Receptors, Leptin Regression Analysis Spectrum analysis |
| title | Increased Intramyocellular Lipid Concentration Identifies Impaired Glucose Metabolism in Women With Previous Gestational Diabetes |
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