Abstract
Due to the intermittency of our eating pattern, all human intermediary metabolism can be subdivided into two broad categories: the fed state and the fasted state. The fed state begins whenever we eat and metabolic objectives are oriented to provide optimum utilization of ingested nutrients. The fasting state is initiated when levels of circulating fuels have returned to pre-eating values. Regulatory processes are then geared for the production of fuels from endogenous resources in a manner that is parsimonious and appropriate to prevailing energy needs (Freinkel, 1964a; Freinkel, 1969).
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
references
Beck, P., Daughaday, W.H.: Human placental lactogen: Studies of its acute metabolic effects and disposition in normal man. J. Clin. Invest. 46, 103–110 (1967)
Bellmann, O., Hartmann, E.: Influence of pregnancy on the kinetics of insulin. Am. J. Obstet, Gynecol. 122, 829–833 (1975)
Bleicher, S.J., O’Sullivan, J.B., Freinkel, N.: Carbohydrate metabolism in pregnancy. V. The interrelations of glucose, insulin, and free fatty acids in late pregnancy and postpartum. N. Engl. J. Med. 271, 866–872 (1964)
Bonsnes, R.W.: The plasma amino acid and amono nitrogen concentration during normal pregnancy, labor, and early puerperium. J. Biol. Chem. 168, 345–350 (1947)
Bourdel, G., Jacquot, R.: Role du placenta dans les facultes anabolisantes des Rattes gestantes. C.R. Acad. Sci. D. (Paris) 242, 552–555 (1956)
Burd, L.I., Jones, M.D., (Jr.), Simmons, M.A., Makowski, E.L., Meschia, G., Battaglia, F.C.: Placental production and foetal utilisation of lactate and pyruvate. Nature 254, 71o–711 (1975)
Burt, R.L.: Plasma nonesterified fatty acids in normal pregnancy and the puerperium. Obstet. Gynecol. 15, 460–463 (1960)
Cahill, G.G., (Jr.), Owen, O.E.: Some observations on carbohydrate metabolism in man. In: Carbohydrate metabolism and its disorders. Dickens, F., Randle, P.J., Whelan, W.J. (eds.), pp. 497–522. New York: Academic Press 1968
Campbell, R.M., Innes, I.R., Kosterlitz, H.W. : Some dietary and hormonal effects on maternal, foetal and placental weights in the rat. J. Endocrinol. 9, 68–75 (1953)
Christensen, P.J., Date, J.W., Schonheyder, F., Volqvartz, K.: Amino acids in blood plasma and urine during pregnancy. Scand. J. Clin. Lab. Invest. 9, 54–61 (1957)
Churchill, J.A., Berendes, H.W.: Intelligence of children whose mothers had acetonuria during pregnancy. In: Perinatal factors affecting human development. Washington, D.C.: Pan American Health Organization, Sci. Pub. 185, p. 30, 1969
Cornblath, M., Schwartz, R.: Disorders of carbohydrate metabolism in infancy. 2nd ed., pp. 29–71, Philadelphia: W.B. Saunders 1976
Curry, D.M., Beaton, G.H.: Cortisone resistance in pregnant rats. Endocrinology 63, 155–161 (1958)
Daniel, R.R., Metzger, B.E., Freinkel, N., Faloona, G., Unger, R.H., Nitzan, M.: Carbohydrate metabolism in pregnancy. XI. Response of plasma glucagon to overnight fast and oral glucose during normal pregnancy and in gestational diabetes. Diabetes 23, 771–776 (1974)
Diamant, S., Diamant, Y.Z., Freinkel, N.: Placental phospholipid metabolism. Proc. 2nd Int. congr. human reproduction, Tel Aviv (Israel), October 23-28, 1977b
Diamant, Y.Z., Diamant, S., Freinkel, N.: Aging of the placenta and changes in its triglyceride metabolism. Proc. 2nd int. congr. human reproduction. Tel Aviv (Israel), October 23-28, 1977a
Drazancic, A., Stavlenic, A.: Free fatty acid determinations in normal and abnormal pregnancies. Am. J. Obstet. Gynecol. 109, 666–669 (1971)
Elliott, J.A.: The effect of pregnancy on the control of lipolysis in fat cells isolated from human adipose tissue. Eur. J. Clin. Invest. 5, 159–163 (1975)
Fairweather, D.V.I.: Changes in levels of serum non-esterified fatty acid and blood glucose in pregnancy. Br. J. Obstet. Gynaecol. 78. 707–711 (1971)
Fajans, S.S., Floyd, J.C., (Jr.): Fasting hypoglycemia in adults. N. Engl. J. Med. 294, 766–772 (1976)
Felig, P., Jin Kim, Y., Lynch, V., Hendler, R.: Amino acid metabolism during starvation in human pregnancy. J. Clin. Invest. 51, 1195–1201 (1972)
Freinkel, N.: Effects of the conceptus on maternal metabolism during pregnancy-In: On the nature and treatment of diabetes. Leibel, B.S., Wrenshall, G.A. (eds.), pp. 679–691. Amsterdam: Excerpta Medica Foundation 1965
Freinkel, N.: Homeostatic factors in fetal carbohydrate metabolism. In: Fetal homeostasis. Wynn, R.N. (ed.), pp. 85–140. New York: Century Crofts 1969
Freinkel, N.: Hypoglycemic disorders. In: Textbook of Medicine. Beeson, P.B., McDermott, W. (eds.), pp. 1619–1624. Philadelphia: W.B. Saunders 1975
Freinkel, N., Goodner, C.J.: Carbohydrate metabolism in pregnancy. I. The metabolism of insulin by human placental tissue. J. Clin. Invest. 39, 116–131 (1960)
Freinkel, N., Goodner, C.J.: Insulin metabolism and pregnancy. Arch. Intern. Med. 109, 235–244 (1962)
Freinkel, N.: Aspects of the endocrine regulation of lipid metabolism. In: Metabolism and Physiological Significance of Lipids Dawson, R.M.C., Rhodes, D.N. (eds.), pp. 455–479. London: John Wiley 1964a
Freinkel, N. : The effect of pregnancy on insulin homeostasis. Diabetes 13 260–267 (1964b)
Freinkel, N., Metzger, B.E.: Some considerations of fuel economy in the fed state during late human pregnancy. In: Early diabetes in early life. Camerini-Davalos, R., Cole, H.S. (eds.), pp. 289–301. New York: Academic Press 1975
Freinkel, N., Metzger, B.E.: The critical implications of maternal metabolism for fetal development. In: Pregnancy metabolism, diabetes and the fetus. Proc. Ciba Found. Symp. No. 63 London: Ciba Foundation 1978 (in press)
Freinkel, N., Herrera, E., Knopp, R.H., Ruder, H.J.: Metabolic realignments in late pregnancy: A clue to diabetogenesis? In: Early diabetes. Camerini-Davalos, R.A., Cole, H.S. (eds.), pp. 205–219. New York: Academic Press 1970
Freinkel, N., Metzger, B.E., Herrera, E., Agnoli, F., Knopp, R.H.: The effects of pregnancy on metabolic fuels. In: Proc. Vllth Congr. Int. Diabetes Fed. Buenos Aires (Argentina): Excerpta Medica Int. Congr. Series No. 231, 656-666 (1971)
Freinkel, N., Metzger, B.E., Nitzan, M., Hare, J.W., Shambaugh, G.E., III, Marshall, R.T., Surmaczynska, B.Z., Nagel, T.C.: “Accelerated starvation” and mechanisms for the conservation of maternal nitrogen during pregnancy. Isr. J. Med. Sci. 8, 426–439 (1972)
Freinkel, N., Metzger, B.E., Nitzan, M., Daniel, R., Surmaczynska, B., Nagel, T.: Facilitated anabolism in late pregnancy: Some novel maternal compensations for accelerated starvation. In: Proc. Vlllth congr. int. diabetes fed. Malaise, W.J., Pirart, J. (eds.). Amsterdam: Excerpta Medica, Int. Congr. Series No. 312, 474–488 (1974)
Gillmer, M.D.G., Beard, R.W., Brooke, F.M., Oakley, N.W.: Carbohydrate matabolism in pregnancy. Part I. Diurnal plasma glucose profile in normal and diabetic women. Br. Med. J. 3, 339–402 (1975a)
Gillmer, M.D.G., Oakley, N.W., Brooke, F.M., Beard, R.W.: Metabolic profiles in pregnancy. Isr. J. Med. Sci. 11, 601–608 (1975b)
Gillmer, M.D.G., Beard, R.W., Oakley, N.W., Brooke, F.M., Elphick, M.C., Hull, D.: Diurnal plasma free fatty acid profiles in normal and diabetic pregnancies. Br. Med. J. 2, 670–673 (1977)
Girard, J.R., Cruendet, G.S., Marliss, E.B., Kervran, A., Rieutort, M., Assan, R.: Fuels, hormones, and liver metabolism at term and during the early postnatal period in the rat. J. Clin. Invest. 52, 3190–3200 (1973)
Girard, J.R., Ferre, P., Gilbert, N., Kervran, A., Assan, R., Marliss, E.B.: Fetal metabolic responses to maternal fasting in the rat. Am. J. Physiol. 232, E456–E463 (1977)
Goodner, C.J., Freinkel, N.: Carbohydrate metabolism in pregnancy: The degradation of insulin by extracts of maternal and fetal structures in the pregnant rat. Endocrinology 65, 957–967 (1959)
Goodner, C.J., Freinkel, N.: Carbohydrate matabolism in pregnancy: The turnover of I insulin in the pregnant rat. Endocrinology 67, 862–872 (1960)
Goodner, C.J., Freinkel, N.: Carbohydrate matabolism in pregnancy. IV. Studies on the permeability of the rat placenta to I insulin. Diabetes 10, 383–392 (1961)
Gresham, E.L., James, E.J., Raye, J.R., Battaglia, F.E., Makowski, E.L., Meschia, G. : Production and excretion of urea by the fetal lamb. Pediatrics 50, 372–379 (1972)
Herrera, E., Freinkel, N.: Metabolites in the liver, brain and placenta of fed or fasted mothers and fetal rats. Horm. Metab. Res.1, 247 (1975)
Herrera, E., Knopp, R.H., Freinkel, N.: Carbohydrate metabolism in pregnancy. VI. Plasma fuels, insulin, liver composition, gluconeogenesis and nitrogen metabolism during late gestation in the fed and fasted rat. J. Clin. Invest. 48, 2260–2272 (1969a)
Herrera, E., Knopp, R.H., Freinkel, N.: Urinary excretion of epinephrine and norepinephrine during fasting in late pregnancy in the rat. Endocrinology 84, 447–450 (1969b)
Jost, A., Picon, L.: Hormonal control of fetal development and metabolism. In: Advances in metabolic disorders. Levine, R., Luft, R. (eds.), Vol. IV, pp. 123–184. New York: Academic Press 1970
Kalkhoff, R., Schalch, D.S., Walker, L., Beck, P., Kipnis, D.M., Daughaday, W.H.: Diabetogenic factors associated with pregnancy. Trans. Assoc. Am. Physicians 77, 270–279 (1964)
Kalkhoff, R.K., Jacobson, M., Lemper, D. : Progesterone, pregnancy and the augmented plasma insulin response. J. Clin. Endocrinol. 31, 24–28 (1970)
Katz, A.I., Lindheimer, M.D., Mako, M.E., Rubenstein, A.H.: Peripheral metabolism of insulin, proinsulin, and C-peptide in the pregnant rat. J. Clin. Invest. 56, 1608–1614 (1975)
Knopp, R.H., Herrera, E., Freinkel, N.: Carbohydrate metabolism in pregnancy. VIII. Metabolism of adipose tissue isolated from fed and fasted pregnant rats during late gestation. J. Clin. Invest. 49, 1438–1446 (1970a)
Knopp, R.H., Ruder, H.J., Herrera, E., Freinkel, N.: Carbohydrate metabolism in pregnancy. VII. Insulin tolerance during late pregnancy in the fed and fasted rat. Acta Endocrinol. 65, 352–360 (1970b)
Knopp, R.H., Warth, M.R., Carrol, C.J.: Lipid metabolism in pregnancy. I. Changes in lipoprotein triglyceride and cholesterol in normal pregnancy and the effects of diabetes mellitus. J. Reprod. Med. 10, 95–101 (1973)
Kühl, C.: Serum proinsulin in normal and gestational diabetic pregnancy. Diabetologia 12 295–300 (1976)
Kühl, C., Hoist, J.J.: Plasma glucagon and the insulin:Glucagon ratio in gestational diabetes. Diabetes 25, 16–23 (1976)
Landau, R.L., Lugibihl, K.: The effect of progesterone on the concentration of plasma amino acids in man. Metabolism 16, 1114–1122 (1967)
Lewis, S.B., Wallin, J.D., Kuzuya, H., Murray, W.K., Coustan, D.R., Daane, T.A., Rubenstein, A.H.: Circadian variation of serum glucose, C-peptide immunoreactivity and free insulin in normal and insulin-treated diabetic pregnant subjects. Diabetologia 12, 343–350 (1976)
Lind, T., Bell, S., Gilmore, E., Huisjes, H.J., Schally, A.V.: Insulin, disappearance rate in pregnant and non-pregnant women, and in non-pregnant women given GHRIH. Eur. J. Clin. Invest. 7, 47–51 (1977)
Luyckx, A.S., Gerard, J., Gaspard, U., Lefebvre, P.J.: Plasma glucagon levels in normal women during pregnancy. Diabetologia 11, 549–554 (1975)
Marshall, R.N., Underwood, L.E., Voina, S.J., Foushee, D.B., Van Wyck, J.J.: Characterization of the insulin and somatomedin-C receptors in human placental cell membranes. J. Clin. Endocrinol. Metab. 39, 283–292 (1974)
McDonald-Gibson, R.G., Young, M., Hytten, F.E.: Changes in plasma non esterified fatty acids and serum glycerol in pregnancy. Br. J. Obstet. Gynaecol. 82, 460–466 (1975)
Merimee, T.J., Fineberg, S.E.: Homeostasis during fasting. II. Hormone substrate differences between man and women. J. Clin. Endocrinol. Metab. 37., 698–702 (1973)
Metzger, B.E., Freinkel, N.: Regulation of maternal protein metabolism and gluconeogenesis in the fasted state. In: Early diabetes in early life. Camerini- Davalos, R.A., Cole, H.S. (eds.), pp. 303–311. New York: Academic Press 1975
Metzger, B.E., Agnoli, F., Freinkel, N.: Effect of sex and pregnancy on formation of urea and ammonia during gluconeogenesis in the perfused rat liver. Horn. Metab. Res. 2, 367–369 (1970)
Metzger, B.E., Hare, J.W., Freinkel, N.: Carbohydrate metabolism in pregnancy. IX. Plasma levels of gluconeogenic fuels during fasting in the rat. J. Clin. Endocrinol. 33, 869–873 (1971)
Metzger, B.E., Agnoli, F., Hare, J.W., Freinkel, N.: Carbohydrate metabolism in pregnancy. X. Metabolic disposition of alanine by the perfused liver of the fasting pregnant rat. Diabetes 22, 601–608 (1973)
Metzger, B.E., Werner, H., Freinkel, N.: Altered hepatic nitrogen metabolism: A new property of placental lactogen, p. 112. Program 57th Annual Meeting, Endocrine Soc. 1975
Metzger, B.E., Unger, R.G., Freinkel, N.: Carbohydrate matabolism in pregnancy. XIV. Relationships between circulating glucagon, insulin, glucose, and amino acids in response to “mixed meal” in late pregnancy. Metabolism 26, 151–156 (1977)
Nitzan, M., Freinkel, N., Metzger, B.E., Unger, R.H., Faloona, G.R., Daniel, R.R.: The interrelations of glucose, insulin and glucagon after overnight fast and in response to oral glucose during late pregnancy. Isr. J. Med. Sci. 11, 617–622 (1975)
Oliver, M.F., Boyd, G.S.: Plasma lipid and serum lipoprotein patterns during pregnancy and puerperium. Clin. Sci. 14, 15–23 (1955)
O’Sullivan, J.B., Mahan, C.M.: Criteria for the oral glucose tolerance test in pregnancy. Diabetes 13, 278–285 (1964)
Page, E.W.: Human fetal nutrition and growth. Am. J. Obstet. Gynaecol. 104, 378–387(1969)
Pedersen, J.: The pregnant diabetic and her newborn, 2nd ed., pp. 106–122. Baltimore: Williams and Wilkins 1977
Persson, B.: Assessment of metabolic control in diabetic pregnancy. In: Size at Birth. Elliot, K., Knight, J. (eds.). Ciba Found. Symp. (New Series) 27_, 247-267 (1974)
Persson, B., Lunell, N.O.: Metabolic control in diabetic pregnancy: Variations in plasma concentrations of glucose, free fatty acids, glycerol, ketone bodies, insulin, and human chorionic somatomammotropin during the last trimester. Am. J. Obstet. Gynaecol. 122, 737–745 (1975)
Phelps, R.L., Bergenstal, R., Freinkel, N., Rubenstein, A.H., Metzger, B.E., Mako, M.: Carbohydrate matabolism in pregnancy. XIII. Relationships between plasma insulin and proinsulin during late pregnancy in normal and diabetic subjects. J. Clin. Endocrinol. Metab. 41, 1085–1091 (1975)
Picard, C., Ooms, H.A., Balasse, E., Conard, V.: Effect of normal pregnancy on glucose assimilation, insulin, and non-esterified fatty acids levels. Diabetologia 4, 16–19 (1968)
Posner, B.I.: Insulin metabolizing enzyme activities in human placental tissue. Diabetes 22, 552–563 (1973)
Posner, B.I.: Insulin receptors in human and animal placental tissue. Diabetes 23, 209–217 (1974)
Ravnikar, V., Metzger, B.E., Freinkel, N.: Is there a risk of “accelerated starvation” in normal human pregnancy? Diabetes 21, 463 (1978)
Scow, R.O., Chernick, S.S., Smith, B.B.: Ketosis in the rat fetus. Proc. Soc. Exp. Med. 98, 833–835 (1958)
Scow, R.O., Chernick, S.S., Brinley, M.S.: Hyperlipemia and ketosis in the pregnant rat. Am. J. Physiol. 206, 796–804 (1964)
Shambaugh III., G.E., Mrozak, S.C., Freinkel, N.: Fetal fuels. I. Utilization of ketones by isolated tissues at various stages of maturation and maternal nutrition during late gestation. Metabolism 26, 623–636 (1977a)
Shambaugh III, G.E., Koehler, R.A., Freinkel, N,: Fetal fuels. II. Contributions of selected carbon fuels to oxidative metabolism in the rat conceptus. Am. J. Physiol. 233, E457–E461 (1977b)
Spellacy, W.N., Goetz, F.C.: Plasma insulin in normal late pregnancy. N. Engl. J. Med. 268, 988–991 (1963)
Stehbens, J.A., Baker, G.L., Kitchell, M.: Outcome at ages 1, 3, and 5 years of children born to diabetic women. Am. J. Obstet, Gynaecol. 127, 408–413 (1977)
Svanborg, A., Vikrot, O.: Plasma lipid fractions, including individual phospholipids, at various stages of pregnancy. Acta Med. Scand. 178, 615–630 (1965)
Treharne, I.A.L., Sutherland, H.W., Stowers, J.M., Ross, I.S.: Maternal plasma glucose and free fatty acid concentrations related to infant birth weight. Br. J. Obstet. Gynaecol. 84, 272–280 (1977)
Turtle, J.R., Kipnis, D.M.: The lipolytic action of human placental lactogen on isolated fat cells. Biochim. Biophys. Acta 144, 583–593 (1967)
Tyson, J.E., Austin, K.L., Farinholt, J.W. : Prolonged nutritional deprivation in pregnancy: Changes in human chorionic somatomammotropin and growth hormone secretion. Am. J. Obstet. Gynecol. 109, 1080–1082 (1971)
Tyson, J.E., Austin, K., Farinholt, J., Fiedler, J.: Endocrine-matabolic response to acute starvation in human gestation. Am. J. Obstet. Gynecol. 125, 1073–1084 (1976)
Villee, C.A.: The metabolism of human placenta in vitro. J. Biol. Chem. 205, 113–123 (1953)
Winick, M., Noble, A.: Quantitative changes in ribonucleic acids and protein during normal growth of rat placenta. Nature 212, 34–35 (1966)
Winick, M., Coscia, A., Noble, A.: Cellular growth in human placenta. I. Normal placental growth. Pediatrics 39, 248–251 (1967)
Young, M.: Placental transfer of glucose and amino acids. In: Early diabetes in early life. Camerini-Davalos, R.A., Cole, H.S. (eds.), pp. 237–242. New York: Academic Press 1975
Young, M., Prenton, M.A.: Maternal and fetal plasma amino acid concentrations during gestation and in retarded fetal growth. Br. J. Obstet. Gynaecol. 76, 333–344 (1969)
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1979 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Freinkel, N., Phelps, R.L., Metzger, B.E. (1979). Intermediary Metabolism During Normal Pregnancy. In: Sutherland, H.W., Stowers, J.M. (eds) Carbohydrate Metabolism in Pregnancy and the Newborn 1978. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-66972-9_1
Download citation
DOI: https://doi.org/10.1007/978-3-642-66972-9_1
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-08798-4
Online ISBN: 978-3-642-66972-9
eBook Packages: Springer Book Archive