Abstract
To compare cord blood leptin concentrations between normal pregnancy, pregnancy induced hypertension (PIH), and gestational diabetes mellitus (GDM). Cross-sectional study. Academic institutes and a tertiary care maternal hospital. 48 newborns of normal pregnancies (N=18), pregnancy induced hypertension (N=16), and gestational diabetes mellitus (N=14) were studied. Cord blood samples were collected and newborn anthropometric indices recorded at delivery. Leptin concentrations were measured using an enzyme immunoassay. Cord blood leptin levels were significantly different between the 3 groups (Kruskal-Wallis ANOVA; P=0.0064), and the difference resulted mainly from higher levels in GDM than in PIH [geometric mean (95% CI) for GDM: 10.89 (6.30, 18.84) vs PIH: 3.49 (2.14, 5.69) ng/ml (Dunn's multiple comparison: P<0.01). This pattern persisted even when leptin levels were normalized to the ponderal index (Kruskal-Wallis ANOVA P=0.0035; Dunn's multiple comparison: P<0.01). Leptin levels significantly and positively correlated with the ponderal index in normal pregnancy (Spearman r=0.506, p<0.05) and with birth weight in PIH (r=0.5463, p<0.05). In GDM cord blood leptin levels are significantly higher, and a source other than fetal adipocytes appears to contribute to this.
Highlights
Leptin, discovered in 1994, raised much optimism among biomedical researchers dedicated to devising a cure for obesity
Cord blood leptin levels were significantly different between the 3 groups (Kruskal-Wallis ANOVA; P=0.0064), and the difference resulted mainly from higher levels in gestational diabetes mellitus (GDM) than in pregnancy induced hypertension (PIH) [geometric mean for GDM: 10.89 (6.30, 18.84) vs PIH: 3.49 (2.14, 5.69) ng/ml (Dunn's multiple comparison: P
This difference resulted from higher levels in GDM than in PIH [geometric mean for GDM: 10.89 (6.30, 18.84) vs PIH: 3.49 (2.14, 5.69) ng/ml; Dunn’s multiple comparison: P
Summary
Leptin, discovered in 1994, raised much optimism among biomedical researchers dedicated to devising a cure for obesity It is secreted principally by white adipose tissue and regulates metabolic efficiency, energy expenditure and food intake [1]. Others observed similar levels when cord blood leptin was normalised to the fat content in appropriate, small and large for gestational age babies, indicating that cord blood leptin reflects adiposity rather than being a regulator of fetal growth [10]. This is further supported by normal birth weight seen in congenital leptin deficiency [11]. There are hardly any studies on cord blood leptin levels from south Asia, where prevalence of metabolic disorders is increasing
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