Ng P C, Lam C W, Lee C H, Wong G W, Fok T F, Wong E, Ma K C, Chan I H
Department of Paediatrics, Level 6, Clinical Science Building, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong.
Arch Dis Child Fetal Neonatal Ed. 2000 Nov;83(3):F193-7. doi: 10.1136/fn.83.3.f193.
To investigate the effect of maternal diabetes on leptin in term newborns and to determine whether leptin correlates with insulin and its associated biochemical parameters in support of the hypothesis that a functional "adipoinsular axis" might exist at this stage of development.
A total of 116 term newborns were prospectively enrolled and categorised into three groups: 44 were infants of non-diabetic mothers (control group C); 41 were infants born to mothers with gestational diabetes on dietary treatment (group D); and 31 were infants born to mothers with gestational or pregestational diabetes on insulin treatment (group I).
No significant difference in serum leptin was observed between the three groups; the results of the study population were therefore pooled and analysed. Serum leptin correlated significantly with serum insulin, insulin:glucose ratio, birth weight, body length, body mass index, placenta weight, and maternal HbA(1c). Female infants had significantly higher serum leptin than male infants. All parameters except placenta weight and body length remained significantly associated with serum leptin when multivariate stepwise regression analysis was applied. Subgroup analysis revealed a significant correlation between serum leptin and cortisol in group D.
There was no significant difference in serum leptin between infants born to diabetic and non-diabetic mothers, though infants born to mothers requiring insulin treatment had the highest median serum leptin concentrations. The significant association between serum leptin and insulin or insulin:glucose ratio supports the hypothesis that a functional adipoinsular axis might exist in term newborns. Furthermore, the significant correlation between maternal HbA(1c) and circulating leptin of the studied infants suggests that the clinical control of maternal diabetes could affect the regulation of serum leptin in these infants.
研究母亲患糖尿病对足月儿瘦素的影响，并确定瘦素是否与胰岛素及其相关生化参数相关，以支持在这一发育阶段可能存在功能性“脂肪-胰岛轴”的假说。
前瞻性纳入116名足月儿并分为三组：44名是非糖尿病母亲的婴儿（对照组C）；41名是接受饮食治疗的妊娠期糖尿病母亲所生婴儿（D组）；31名是接受胰岛素治疗的妊娠期或孕前糖尿病母亲所生婴儿（I组）。
三组之间血清瘦素无显著差异；因此将研究人群的结果合并并分析。血清瘦素与血清胰岛素、胰岛素：葡萄糖比值、出生体重、身长、体重指数、胎盘重量和母亲糖化血红蛋白（HbA1c）显著相关。女婴的血清瘦素显著高于男婴。应用多变量逐步回归分析时，除胎盘重量和身长外，所有参数与血清瘦素仍显著相关。亚组分析显示D组血清瘦素与皮质醇之间存在显著相关性。
糖尿病母亲和非糖尿病母亲所生婴儿的血清瘦素无显著差异，尽管需要胰岛素治疗的母亲所生婴儿的血清瘦素中位数浓度最高。血清瘦素与胰岛素或胰岛素：葡萄糖比值之间的显著相关性支持足月新生儿可能存在功能性脂肪-胰岛轴的假说。此外，母亲糖化血红蛋白（HbA1c）与所研究婴儿循环瘦素之间的显著相关性表明，母亲糖尿病的临床控制可能会影响这些婴儿血清瘦素的调节。
