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Leptin in diabetic pregnancy
  1. M Higgins1,
  2. N Russell1,
  3. D Brazil2,
  4. F McAuliffe1
  1. 1Obstetrics and Gynaecology, University College Dublin, Dublin, Ireland
  2. 2Conway Institute, University College Dublin, Dublin, Ireland

Abstract

Leptin is involved in the regulation of body weight. The aim of this study was to study maternal and cord leptin in non-diabetic, type 1 diabetic and type 2 (pregestational diabetic, PGDM) diabetic pregnancies.

Prospective cohort study with maternal serum samples obtained at 36-week gestation and cord blood at delivery. Clinical data on both normal and PGDM pregnancies was obtained. Leptin was measured by enzyme-linked immunoassay (Human Leptin Immunoassay; R&D Systems, Minneapolis, Minnesota, USA). Non-parametric data were compared using Mann–Whitney or Kruskal Wallis tests.

40 women with T1DM, 10 women with T2DM and 30 non-diabetic women consented to the study. There was no difference in maternal body mass index (BMI) between the three groups. Infants of PGDM pregnancy had a higher birthweight centile. There was no difference in maternal leptin levels at 36-week gestation. Cord leptin was higher in infants of both T1DM (223 pg/ml (25.7–810 pg/ml)) and T2DM (447.2 pg/ml (136.3–679 pg/ml)) compared to infants of non-diabetic mothers (80.3 pg/ml (27.3–623.1 pg/ml)) (p<0.05).

Among the PGDM group only third trimester HbA1c significantly related to cord leptin after controlling for birth weight, birthweight centile and maternal BMI (r=0.28, p=0.04).

Infants of diabetic mothers may have some degree of leptin resistance, which could be have an important role in appetite regulation in extra-uterine life. This research reiterates the importance of tight glycaemic control in the third trimester of pregnancy in women with pregestational diabetes.

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