Created by :

Dethiya Ruspa Andiyani (20170302157)

Syiva Nurul Faridah (20170302142)

 Lipid Metabolism in normal condition

 Lipid Metabolism during pregnancy

 Metabolic changes during pregnancy

 Disorders of Lipid Metabolism during Pregnancy

“Metabolism Lipid in Normal Condition”
 Fat is a macro nutrient that has an important role for the body to
store the excess energy that tastes from food. Individual fat
requirement is about 20-30% of total energy requirement.

fat is one source of energy that produces the largest calori for each
gram, which is 9 kcal.
Fat does its digestive process in the duodenum.

In the stomach, with the help of lingual lipase

enzyme will process the hydrolysis of triglycerides
into diglycerides and fatty acids

This process breaks down the fat clots that enter the
body from the food and increases the surface of the
fatty areas that can come into contact with the lipase
enzyme from the pancreas.

Lipase can break down fat into fatty acids and

glycerol in the absorption of the thirst intestine.

From the small intestine, the fat will be

regenerated and formed into a protein called
chylomicron.
Triasilgliserol Kolesterol Apolipoprotein Kilomikron
A little fat
Contains
soluble
1-2% protein
vitamin Kilomikro
n

6-7% 85%
Cholesterol Triglycerides
7%
Phospholipids
Then the process of digestion will continue into
the small intestine, some of the fat attached to
the dietary fiber is removed through the feces.

Every day the small intestine absorbs several

hundred grams of carbohydrates, 100 grams or
more fat, 50-100 grams of amino acids, 50 -100
grams of ions and 7-8 liters of water.

These lipoproteins are smaller particles smaller

than kilomicrons but have compositions
containing triglycerides, cholesterol,
phospholipids, and proteins.
 • Good cholesterol
• High HDL is associated with lower
incidence of cardiovascular disease.
• Increased HDL concentrations in the
bloodstream can counteract the
cholesterol pathological deposits in
HDL (High
Density artery walls in the heart.
lipoprotein)
Lipoproteins
LDL (Low
Density
lipoprotein) • Bad cholesterol
• A high concentration of LDL in the
bloodstream is a risk factor for
cardiovascular disease
• LDL acts as a biochemical taxi to
transport cholesterol from one part
of the body to another
“Every aspect of lipid metabolism is influenced
by pregnancy”
AKG 2013, recommends the requirement of fat during pregnancy
in every semester 10 gram / day or total requirement of fat
become 85 gram / day.

Pregnant women need to consider the type of lipid they are

good for the process of pregnancy. Example is essential fatty
acids, such as linoleic acid and linolenic acid and its derivatives
include a DHA
First half of
gestation
increased food intake and the resulting
greater influx of exogenous carbohydrates
and fat, create optimal conditions for lipid
synthesis and storage.

Second half
of gestation
In contrast, food intake declines and insulin
resistance is established. The net result of
these interactions would be a relative
reduction in the rate of lipid accumulation.
Plasma levels of most lipid fractions increase during
pregnancy

 The earliest change in plasma lipids concentration is an

increase in triglycerides

 The increase of FFA (Free Fatty Acid)

 Plasma levels of cholesterol increase during gestation

 Plasma phospholipid levels increase moderately during

gestation

 The hypertriglyceridemia of pregnancy reflects an

increase in both plasma VLDL concentration , LDL and
HDL
Estrogen, alone or as part of oral contraceptives,
increases the endogenous production of VLDL
triglycerides

Thus, the estrogenic influence over triglyceride

metabolism suggest an increased synthesis and
reduced removal
The late gestational increase in FFA and glycerol is compatible with

an increased rate of lipid mobilization from adipose tissue.

The increase in the circulating pool of FFA may have an important

effect on maternal metabolism.

Plasma FFa levels decrease somewhat until week 30 of gestation; then

increase, subsequently and at weeks 37-38 they drop below prepregnancy
values.
 The elevated plasma cholesterol concentration
probably reflects both increased synthesis and
decreased catabolism.
 The increased rate of synthesis is probably
related to changes in lipoprotein metabolism
During the last month of gestation, lysolecithin concentration
decreases, whereas other phospholipid, including sphyngomyielin,
lecithin, and phosphatidyl ethanolamine, tend to increase.

Lecithin and lysolecithin are important componens of lipoprotein

and participate in the conversion of free cholesterol to its ester
form.
 Fatty acids and glycerol, synthesized de novo by
the liver from carbohydrate and amino acid
 Endogenous and exogenous fatty acid sources.
In subjects consuming a balanced diet most of
the VLDL triglycerides derive from endogenous
circulating FFA.
 Source : Pedro Rosso, M.D. 1990. Nutrition and Metabolism in
pregnancy, mother and fetus. New York, Oxford University Press
 Kebutuhan
Sumber Hamil
Zat Gizi Hamil
Makanan Tak Hamil Trimester
Trimester 1
2&3
Daging, Ikan,
Lemak 75 gram +6 gram +10 gram
Telur, Susu

Hamil
Hamil
Zat Gizi 19-25 thn 30-49 thn Trimester
Trimester 1
2&3
Lemak 75 gram 60 gram +6 gram +10 gram
 Komponen Tubuh Persentase (%)
Janin 25-27%
Plasenta 5
Cairan amnion 6
Ekspansi vol. Cairan 10
Pertumbuhan uterus dan payudara 11
Peningkatan cairan ekstraseluler 13
Peningktan lemak tubuh 25-27
 PREGNANT
AKG 2013 , recommends the requirement of fat during pregnancy d each
trimester by 10 g / day or total fat to 85 g / day.
Stimulate growth breast and storage fat
Fat under the skin increased
Solving soft tissue for the fulfillment of energy needs mother

During pregnancy, the mass of fat tissue in the breast and tissue under the skin
increases.

Fat reserves will be useful for breastmilk production.

However, it shoulad pay attention to the type of fat in the consumption or fat is
good for the process of pregnancy.
“Every aspect of lipid metabolism is influenced
by pregnancy”
 Complication  Obesitas
Dyslipidemia
in Pregnancy
 Preeclampsia
 Gestational Diabetes
 Such Postpartum
Complications
 Pedro Rosso, M.D. 1990. Nutrition and Metabolism in pregnancy, mother and fetus. New
York : Oxford University Press.
 Monica Mukherjee MD, MPH. 2014. Dyslipidemia in Pregnancy. American College of
Cardiology.
 Nancy F Butte. 2000. Carbohydrate and lipid metabolism in pregnancy: normal compared
with gestational diabetes mellitus. American Society for Clinical Nutrition.
 Donangelo C.M., and Bezerra F.F. (2016) Pregnancy: Metabolic Adaptations and
Nutritional Requirements. In: Caballero, B., Finglas, P., and Toldrá, F. (eds.) The
Encyclopedia of Food and Health vol. 4, pp. 484-490. Oxford: Academic Press.
 Niman, Susanti. 2013. Anatomi Fisiologi: Sistem Pencernaan. Jakarta: CV. Trans Info
Media.
 Damayanti, Denidya. 2013. Cara Bijak Hancurkan Lemak Jahat.Yogyakarta: Mantra
Boooks.