Investigating Markers of Energy Metabolism in the CNS and Periphery in Pregnant Women With Varying Degrees of Insulin Resistance
| Status: | Completed |
|---|---|
| Conditions: | Endocrine, Diabetes, Diabetes |
| Therapuetic Areas: | Endocrinology |
| Healthy: | No |
| Age Range: | 18 - 45 |
| Updated: | 3/16/2015 |
| Start Date: | February 2014 |
| End Date: | February 2015 |
| Contact: | Robert Sherwin, MD |
| Email: | robert.sherwin@yale.edu |
| Phone: | 203-785-4183 |
The investigators seek to examine the metabolic changes that occur amongst obese and lean
pregnant women with normal glycemic control as well as pregnant women with diabetes mellitus
(gestational diabetes and pre-existing type 2 diabetes mellitus) compared to non-pregnant
age matched controls. Given the adaptive tendency of the maternal body to use alternative
energy sources such as ketones and free fatty acids rather than glucose and to shunt glucose
and amino acids to the fetus, the investigators hypothesize that the amino acid and fatty
acid profile will be reflective of this adaptive change and that maternal insulin resistance
will result in alterations in this pattern in both the plasma and CSF. Furthermore, the
investigators also hypothesize that maternal degrees of insulin resistance will also be
reflected in CSF hormonal changes.
pregnant women with normal glycemic control as well as pregnant women with diabetes mellitus
(gestational diabetes and pre-existing type 2 diabetes mellitus) compared to non-pregnant
age matched controls. Given the adaptive tendency of the maternal body to use alternative
energy sources such as ketones and free fatty acids rather than glucose and to shunt glucose
and amino acids to the fetus, the investigators hypothesize that the amino acid and fatty
acid profile will be reflective of this adaptive change and that maternal insulin resistance
will result in alterations in this pattern in both the plasma and CSF. Furthermore, the
investigators also hypothesize that maternal degrees of insulin resistance will also be
reflected in CSF hormonal changes.
We seek to investigate for the first time whether CSF branched chain amino acid, free fatty
acid, and energy regulatory hormone levels are altered in comparison to plasma levels among
pregnant and non-pregnant individuals with varying degrees of insulin resistance.
Furthermore, we seek to understand the effects of pregnancy on central and peripheral energy
metabolism using metabolomic profiling as well as traditional hormonal measurements in
maternal blood, urine, cerebrospinal fluid as well as cord blood.
acid, and energy regulatory hormone levels are altered in comparison to plasma levels among
pregnant and non-pregnant individuals with varying degrees of insulin resistance.
Furthermore, we seek to understand the effects of pregnancy on central and peripheral energy
metabolism using metabolomic profiling as well as traditional hormonal measurements in
maternal blood, urine, cerebrospinal fluid as well as cord blood.
Inclusion Criteria:
- Pregnant women ages 18-45, pre-pregnancy BMI 18-30 with normal glycemic control
scheduled for an elective cesarean delivery at Yale-New Haven Hospital on the Labor
and Birth unit
- Pregnant women ages 18-45, pre-pregnancy BMI >30 with normal glycemic control
scheduled for an elective cesarean delivery at Yale-New Haven Hospital on the Labor
and Birth unit
- Pregnant women ages 18-45 with diabetes (gestational or pre-existing type 2 DM)
scheduled for an elective cesarean delivery at Yale-New Haven Hospital on the Labor
and Birth unit
- Non-pregnant, non-diabetic women age 18-45 scheduled for lumbar puncture at the
Yale-New Haven Hospital Lumbar puncture clinic
- Able to read and understand English at 6th grade level or higher
Exclusion Criteria:
- Medical disorders other than diabetes. Including psychiatric disorders, alcohol
abuse, HIV, hepatitis, renal, hepatic disease, heart disease, active systemic
infection, malignancy
- Pregnancy related medical problems including preeclampsia
- Major congenital fetal anomalies
- Smoking and illicit drugs (marijuana, cocaine, benzodiazepines, barbituates)
- Use of weight loss supplements or dieting 6 months prior to study.
- Corticosteroid use within 6 months of study.
- Uncontrolled thyroid disease
- Medications other than multivitamin, folic acid, or diabetic medications.
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