LIPID METABOLISM IN PREGNANCY AND WITH PREECLAMPSIA

该项目的总体目标是检查女性的脂类代谢。 有健康的和先兆子痫的怀孕。我们将检验这一假设 患有先兆子痫的女性会加重 高甘油三酯血症，超出正常情况下的生理性升高 怀孕了。高甘油三酯血症与先兆子痫有关。 最近的研究表明，可以观察到甘油三酯和游离脂肪酸的升高 早在怀孕16到20周时就会出现先兆子痫的妇女。 怀孕对母体脂代谢有明显影响。这个 妊娠2、3个月血浆甘油三酯升高 尤其引人注目，比前三个月增加了近3倍 非孕期价值。脂代谢的临床研究进展 在怀孕期间，他们关注的是空腹血脂谱。我们建议 扩大怀孕期间脂代谢的研究范围，包括动态 对进食的反应。 我们提出的四个协议中的第一个将是对 200名初产妇在16周和16周时的餐后脂代谢 再次出现在第32周。基于先兆子痫的发病率约为 5%到10%我们估计在这个队列中有10到20名女性会患上前驱 子痫。第二个方案是关于餐后血脂的研究 接受“高危”妊娠服务的孕妇的代谢 治疗先兆子痫。第三个方案将研究脂解作用，即脂类 产后妇女的氧化和甘油三酯清除 子痫前期妊娠。第四个方案将使用胰岛素 输液/葡萄糖钳夹研究TOP检查产后胰岛素抵抗 患有先兆子痫的女性。 我们将检验这样一个假设，即餐后甘油三酯的异常 代谢在先兆子痫之前和伴随先兆子痫，并与 增强脂肪分解，降低甘油三酯分解代谢和胰岛素 抵抗。

The overall goal of this project is to examine lipid metabolism in women with healthy and pre-eclamptic 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 the 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 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% we estimate that 10 to 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 top 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.