Clinical Significance Of Serum Leptin In Pregnant Women With GDM And GIGT

Objective: To investigate the serum leptin levels in pregnant women with GDM and GIGT and to study its clinical significance.Methods: 36 cases with GDM and GIGT, 82 cases of normal pregnant women (20 in the first, 22 in the second, 40 in the third trimester) and 26 cases of normal non-pregnant women were studied. Radio immunoassay was used to measure the leptin levels at fasting and 3h after oral glucose load(50g) in patients with GDM and GIGT and their umbilical blood.82 shares venous blood and 30 shares umbilical blood were obtained from normal pregnant women for the leptin levels, and so was 26 cases of normal non-pregnant women. In patients with GDM and GIGT, fasting serum insulin levels and HbAlc were measured by Electrochemiluminescent immunoassays and Pressure Liquid Chromatography(LPLC) respectively, glucose levels 1h after the administration of glucose by glucose oxidase method. In the same time neonatal birth weight, placenta weight , the height and the weight of pregnant women at delivery were measured. Leptin levels were correlated with insulin, HbAlc and glucose levels.Results: (1) 4. 5 ±1.6 ng/ml, 10. 0±1.8ng/ml, 14. 9 ±4. 3ng/ml were the mean leptin levels of normal non-pregnant women, normal pregnant women, patients with GDM and GIGT respectively. Maternal serum leptin levels in pregnant women with GDM and GIGT were significantly higher (p<0. 01) than those healthy pregnant women. (2) The levels of fasting serum insulin, glycosylated haemoglobin values and plasma glucose levels obtained Ih after oral administration of 50g glucose were 12.9±4.3mU/L, 6.1 ± 1.1% , 11.0±1.4mmol/L, respectively, whereas the corresponding values in normal controls were 8.6 ± 3.2mU/L, 4. 5±1.0%, 7.8±1.2 mmol/L, there were significant differences in corresponding values between the experiments and the controls. A positive correlation was found between maternal serum leptin levels and fasting serum insulin levels in pregnant women with GDM and GIGT(r=0.835, p<0.01). Apositive correlation was also found between maternal leptin concentrations and glycosylated haemoglobin values, as well as between leptin levels and plasma glucose levels obtained 1 h after the administration of 50g glucose in women with GDM and GIGT (r=0. 758, p<0. 01; r=0. 561, p<0. 01), and so between maternal serum leptin concentrations and overall pregnancy induced maternal weight gain(r=0. 413, P<0. 01). (3) The mean leptin concentrations in cord blood were significantly lower than the corresponding maternal leptin levels, there was no correlation between them. (4) A positive correlation was found between umbilical blood leptin levels and birth weight and placental weight in the newborns of pregnant women with GDM and GIGT (r= 0. 508 and 0. 484 respectively); There were no significant differences in mean cord blood leptin levels of newborns from normal and abnormal mothers(p>0. 05).Conclusions: Serum leptin levels are elevated in pregnant women with GDM and GIGT compared with healthy pregnant women, a positive and significant correlation was found between the maternal leptin levels and fasting insulin levels in pregnant women with GDM and GIGT , as well as between the maternal leptin levels and the severity of GDM and GIGT . Leptin might play an important role in pathogenesis of GDM and GIGT. Elevated leptin levels may be one of the monitor of GDM and GIGT and forecast the risk of metabolism syndrome.Postgraduate: Liu Zengjuan Directed by: Liu Peiqiu...