LIPID METABOLISM IN PREGNANCY AND WITH PREECLAMPSIA

该项目的总体目标是检查脂质代谢， 健康的先兆子痫孕妇。 我们将测试 假设发展为先兆子痫的妇女 高胆固醇血症，超出正常发现的生理升高 怀孕期间 高胆固醇血症与 先兆子痫 最近的研究表明， 和FFA可以观察到早在16至20周的怀孕， 患先兆子痫的女性 妊娠对母体脂质代谢有显著影响。 的 妊娠中期和妊娠晚期血浆甘油三酯升高 尤其引人注目的是， 三个月和非妊娠值。 既往临床研究 妊娠期间的脂质代谢主要集中在空腹脂质 数据区. 我们建议将脂质代谢的研究扩展到 怀孕包括动态反应的膳食摄入。 我们提出的四个协议中的第一个将是纵向的 200例初产妇餐后脂代谢研究 第16周和第32周再次。 根据发生率， 大约百分之五到百分之十的先兆子痫，我们估计， 这个队列中的20名女性将发展为先兆子痫。 第二 方案将是一项研究餐后脂质代谢， 接受“高危”怀孕服务的孕妇， 先兆子痫 第三个方案将是脂解的研究， 产后妇女的脂质氧化和甘油三酯清除 有先兆子痫的孕妇 第四个协议将使用 胰岛素输注/葡萄糖钳夹研究以检查胰岛素抵抗 在患有先兆子痫的产后妇女中。 我们将检验餐后异常 甘油三酯代谢在先兆子痫之前并伴随先兆子痫， 与脂肪分解增强、甘油三酯降低 维生素C和胰岛素抵抗。

The overall goal of this project is to examine lipid metabolism in women with healthy preeclamptic pregnancies. We will test the hypothesis that women who develop pre-eclampsia have an accentuation of hypertriglyceridemia, beyond the physiologic rise normally found in pregnancy. Hypertriglyceridemia has been associated with pre-eclampsia. Recent studies indicate that elevated triglyceride and FFA can be observed as early as 16 to 20 weeks of pregnancy in women who develop pre-eclampsia. Pregnancy has a pronounced effect on maternal lipid metabolism. The increase in plasma triglyceride during the 2nd and 3rd trimesters is especially striking, increasing approximately 3-fold over first trimester and non-pregnant values. Previous clinical investigations of lipid metabolism during pregnancy have focused on fasting lipid profiles. We propose to extend the study of lipid metabolism during pregnancy to include dynamic responses to meal ingestion. The first of the four protocols we propose will be a longitudinal study of postprandial lipid metabolism in 200 primigravida women at week 16 and again at week 32. Based on an incidence of pre-eclampsia of approximately 5 to 10 percent, we estimate that 10 20 women in this cohort will develop pre-eclampsia. The second protocol will be a study of postprandial lipid metabolism in pregnant women admitted to the "high risk" pregnancy service for pre-eclampsia. The third protocol will be a study of lipolysis, lipid oxidation and triglyceride clearance among postpartum women who had pre-eclamptic pregnancies. The fourth protocol will use insulin infusion/glucose clamp studies to examine insulin resistance in postpartum women who had pre-eclampsia. We will test the hypothesis that abnormalities of postprandial triglyceride metabolism precede and accompany pre-eclampsia, and are associated with enhanced lipolysis, decreased triglyceride catabolism and insulin resistance.