Liver-fat accumulation and insulin resistance in obese women with previous gestational diabetes.
OBJECTIVE
We determined whether fat accumulation in the liver is associated with features of insulin resistance independent of obesity.


METHODS
We recruited 27 obese nondiabetic women in whom liver fat (LFAT) content was determined by proton spectroscopy, intra-abdominal and subcutaneous fat by magnetic resonance imaging, and insulin sensitivity by the euglycemic insulin clamp technique. The women were divided based on their median LFAT content (5%) to groups with low (3.2 +/- 0.3%) and high (9.8 +/- 1.5%) liver fat. The groups were almost identical with respect to age (36 +/- 1 vs. 38 +/- 1 years in low vs. high-LFAT), body mass index (32.2 +/- 0.6 vs. 32.8 +/- 0.5 kg/m(2)), waist-to-hip ratio, intra-abdominal, subcutaneous, and total fat content.


RESULTS
Women with high LFAT had features of insulin resistance including higher fasting serum triglyceride (1.93 +/- 0.21 vs. 1.11 +/- 0.09 mM, p < 0.01) and insulin (14 +/- 3 vs. 10 +/- 1 mU/L, p < 0.05) concentrations than women with low LFAT. The group with high LFAT also had higher 24-hour blood pressures, and lower whole-body insulin sensitivity compared with the low-LFAT group.


CONCLUSIONS
In obese women with previous gestational diabetes, LFAT, rather than any measure of body composition, is associated with features of insulin resistance.
Tiikkainen
Mirja
M
Division of Diabetes, Department of Oncology, University of Helsinki, FIN-00029 HUCH, Helsinki, Finland.
Tamminen
Marjo
M
Häkkinen
Anna-Maija
AM
Bergholm
Robert
R
Vehkavaara
Satu
S
Halavaara
Juha
J
Teramo
Kari
K
Rissanen
Aila
A
Yki-Järvinen
Hannele
H
D000273:Adipose Tissue / Q000503:physiopathology*; D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D001823:Body Composition; D001824:Body Constitution; D015992:Body Mass Index; D016640:Diabetes, Gestational / Q000150:complications*; D005260:Female; D015309:Glucose Clamp Technique; D006339:Heart Rate; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008099:Liver / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology*; D011247:Pregnancy; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D007328:Insulin; D014280:Triglycerides