INSULIN SENSITIVITY, HEMODYNAMICS AND ENDOTHELIAL FUNCTION IN WOMAN

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。先兆子痫是妊娠特有的一种高血压疾病，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中心特征，高胰岛素血症、血脂异常和高心输出量是导致内皮功能障碍的机制之一。胰岛素抵抗和高心输出量在产后持续存在，这表明这些妇女有潜在的疾病。目前尚不清楚是否存在与胰岛素抵抗综合征相关的其他共同特征，以及这些特征是否相互关联并导致内皮功能障碍。因此，这项建议的具体目的是：1)评估有先兆子痫病史的产后妇女是否有胰岛素抵抗综合征的特征，这些特征被认为是导致内皮功能障碍的原因；2)通过评估胰岛素抵抗在胰岛素增敏剂改善后这些异常的改善情况，探索胰岛素抵抗与这些已识别特征之间的关系。一项旨在检验特定目标1的病例对照研究将解决这样的假设，即与没有先兆子痫病史的妇女相比，有先兆子痫病史的产后妇女是胰岛素抵抗的，并具有胰岛素抵抗综合征的特征(中心性肥胖、血脂异常、心输出量增加和内皮依赖性血管扩张降低)。

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.