LIPID METABOLISM IN PREGNANCY AND WITH PREECLAMPSIA

这个项目的总体目标是检查人体的脂质代谢。 健康的先兆子痫孕妇。我们将测试 先兆子痫的女性有加重的假说 高甘油三酯血症，超过正常的生理性升高 在怀孕期间。高甘油三酯血症与 先兆子痫。最近的研究表明，升高的甘油三酯 FFA在怀孕16到20周时就可以观察到 患有先兆子痫的女性。 怀孕对母体脂代谢有明显影响。这个 妊娠中晚期血浆甘油三酯升高 尤其引人注目，比第一次增加了大约3倍 怀孕三个月和非怀孕的价值。以往的临床研究 孕期脂代谢的研究主要集中在空腹血脂上 配置文件。我们建议扩大对脂类代谢的研究。 怀孕包括对进食的动态反应。 我们提出的四个协议中的第一个将是纵向的 200例初孕妇女餐后脂代谢的研究 第16周和第32周。根据发生的 大约5%到10%的先兆子痫，我们估计10% 这一队列中的20名女性将患上先兆子痫。第二 方案将是一项关于餐后脂代谢的研究 接受“高危”怀孕服务的孕妇 先兆子痫。第三个方案是关于脂肪分解的研究， 产后妇女的脂质氧化和甘油三酯清除 有先兆子痫怀孕的人。第四个协议将使用 胰岛素输注/葡萄糖钳夹试验检查胰岛素抵抗 在患有先兆子痫的产后妇女中。 我们将检验这样一种假设，即餐后异常 甘油三酯代谢先于和伴随先兆子痫，以及 与脂肪分解增强，甘油三酯降低有关 分解代谢和胰岛素抵抗。

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.