title: Relationship between insulin resistance and tissue blood flow in preeclampsia.
abstract: OBJECTIVE
  Preeclampsia is characterized by generalized endothelial dysfunction and impaired maternal tissue perfusion, and insulin resistance is a prominent feature of this disease. The aim of this study was to test the hypothesis that insulin resistance in preeclampsia is related to the reduced resting tissue blood flow.
  
  
  METHODS
  We used venous occlusion plethysmography to compare the resting calf muscle blood flow (measured as QaU) in 20 nulliparous women with preeclampsia and 20 normal pregnant controls matched for maternal age, gestational age, parity and BMI during the third trimester. Fasting blood samples were obtained to measure the plasma concentrations of insulin and glucose, and to calculate the fasting insulin resistance index (FIRI), a measure of insulin resistance in both groups of women.
  
  
  RESULTS
  Calf blood flow was significantly reduced in the preeclampsia group (1.93 ± 0.86 QaU), compared with normal pregnant controls (3.94 ± 1.1 QaU, P < 0.001). Fasting insulin concentrations and Insulin Resistance Index were significantly higher in preeclampsia compared with normal pregnancy (P < 0.001 for both variables). There were significant inverse correlations between resting calf blood flow and fasting insulin concentrations (r = -0.57, P = 0.008) and FIRI (r = -0.59, P = 0.006) in preeclampsia, but not in normal pregnancy.
  
  
  CONCLUSIONS
  These findings support our hypothesis and raise the possibility that reduced tissue blood flow may a play a role in the increased insulin resistance seen in preeclampsia.
authors.affiliation: aDepartment of Obstetrics and Gynaecology, Kingston Hospital, Kingston upon Thames, Surrey bAcademic Department of Obstetrics and Gynaecology, Faculty of Medicine, Imperial College London, Chelsea & Westminster Hospital, London cSchool of Sports and Exercise Sciences, University of Birmingham, Birmingham, UK.
authors.forename: Nick
authors.initials: N
authors.lastname: Anim-Nyame
authors.forename: John
authors.initials: J
authors.lastname: Gamble
authors.forename: Suren R
authors.initials: SR
authors.lastname: Sooranna
authors.forename: Mark R
authors.initials: MR
authors.lastname: Johnson
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Steer
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D016022:Case-Control Studies; D005215:Fasting; D005260:Female; D005865:Gestational Age; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D007866:Leg / Q000098:blood supply*; D010298:Parity; D011225:Pre-Eclampsia / Q000503:physiopathology*; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D012039:Regional Blood Flow
chemical_list: D001786:Blood Glucose; D007328:Insulin