INSULIN SENSITIVITY, HEMODYNAMICS AND ENDOTHELIAL FUNCTION IN WOMAN

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。先兆子痫是妊娠期特有的高血压疾病，是孕产妇和新生儿发病率和死亡率的主要原因。内皮功能障碍是子痫前期病理生理的核心特征，内皮功能障碍的机制包括高胰岛素血症、血脂异常和心输出量高。胰岛素抵抗和高心输出量在产后持续存在，表明这些女性有潜在的疾病。目前尚不清楚是否存在与胰岛素抵抗综合征相关的其他特征，以及这些特征是否与内皮功能障碍有关。因此，本建议的具体目的是：1)评估产后有子痫前期病史的妇女的胰岛素抵抗综合征特征，这些特征被认为有助于内皮功能障碍；2)通过评估胰岛素增敏剂改善胰岛素抵抗后这些异常的改善，探索胰岛素抵抗与这些已确定的特征之间的关系。一项旨在检验特定目的1的病例对照研究将提出这样的假设：与没有子痫前期病史的妇女相比，有子痫前期病史的产后妇女有胰岛素抵抗，并且具有胰岛素抵抗综合征的特征（中枢性肥胖、血脂异常、心输出量升高、内皮依赖性血管舒张功能降低）。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Preeclampsia, a hypertensive disorder unique to pregnancy, is leading cause of maternal and neonatal morbidity and mortality. Endothelial dysfunction is a central feature in the pathophysiology of preeclampsia and mechanisms that have been suggested to contribute to the endothelial dysfunction include hyperinsulinenmia, dyslipidemia, and high cardiac output. Insulin resistance and high cardiac output persist postpartum, suggesting that these women have an underlying disorder. It is unknown whether there is persistence of other features commonly associated with the insulin resistance syndrome and whether these features are linked and contribute to endothelial dysfunction. Thus, the specific aims of this proposal are: 1) Evaluate postpartum women with a history of preeclampsia for features of the insulin resistance syndrome that are thought to contribute to endothelial dysfunction, and 2) Explore the relationships between insulin resistance and these identified features by evaluating for improvement in these abnormalities after insulin resistance is ameliorated with an insulin sensitizing agent. A case-control study, designed to examine specific aim 1, will address the hypothesis that postpartum women with a history of preeclampsia are insulin resistant and have features of the insulin resistance syndrome (central adiposity, dyslipidemia, elevated cardiac output, and decreased endothelial dependent vasodilation) as compared to women without a history of preeclampsia.