Cetin I, Morpurgo P S, Radaelli T, Taricco E, Cortelazzi D, Bellotti M, Pardi G, Beck-Peccoz P
Department of Obstetrics and Gynecology, Ospedale San Paolo, Milan, Italy.
Pediatr Res. 2000 Nov;48(5):646-51. doi: 10.1203/00006450-200011000-00016.
The relationship between in utero fetal growth and fetal leptin concentrations was investigated between 19 and 41 wk in 40 normal (appropriate for gestational age, AGA) fetuses, in 25 intrauterine growth-restricted (IUGR) fetuses, and in 18 fetuses from gestational diabetic mothers (GDM), representing different intrauterine growth patterns. Umbilical venous plasma leptin concentrations were determined at the time of either in utero fetal blood sampling or delivery. Plasma leptin was measurable as early as 19 wk of gestation. A significant difference was observed between umbilical venous and arterial plasma leptin concentrations (0.6+/-0.6 ng/mL; p<0.01). In AGA and in IUGR fetuses, significant positive relationships were found between fetal leptin concentrations and both gestational age (p<0.001) and fetal weight (p<0.001). Leptin concentrations were significantly higher in AGA than IUGR only after 34 wk (p<0.05), but leptin per kilogram fetal weight (leptin/kg) was not significantly different. In IUGR with abnormal umbilical arterial Doppler velocimetry and fetal heart rate, leptin/kg significantly higher than in IUGR with normal biophysical and biochemical parameters was found (p<0.05). Both circulating plasma leptin and leptin/kg were significantly higher in GDM than in normal fetuses (p<0.001) and correlated with abdominal fat mass measured by ultrasound. No gender differences were observed in any group of fetuses. These findings indicate a clear relationship between fetal leptin concentrations and fetal fat mass. Data in severe IUGR suggest the presence of increased leptin concentrations associated with in utero signs of fetal distress.
在40例正常（适于胎龄，AGA）胎儿、25例宫内生长受限（IUGR）胎儿和18例患有妊娠期糖尿病母亲（GDM）的胎儿中研究了孕19至41周时子宫内胎儿生长与胎儿瘦素浓度之间的关系，这些胎儿代表了不同的子宫内生长模式。在子宫内胎儿采血或分娩时测定脐静脉血浆瘦素浓度。早在妊娠19周时就可检测到血浆瘦素。观察到脐静脉和动脉血浆瘦素浓度之间存在显著差异（0.6±0.6 ng/mL；p<0.01）。在AGA和IUGR胎儿中，发现胎儿瘦素浓度与胎龄（p<0.001）和胎儿体重（p<0.001）均呈显著正相关。仅在34周后，AGA胎儿的瘦素浓度显著高于IUGR胎儿（p<0.05），但每千克胎儿体重的瘦素（瘦素/千克）无显著差异。在脐动脉多普勒测速和胎儿心率异常的IUGR胎儿中，发现瘦素/千克显著高于生物物理和生化参数正常的IUGR胎儿（p<0.05）。GDM胎儿的循环血浆瘦素和瘦素/千克均显著高于正常胎儿（p<0.001），且与超声测量的腹部脂肪量相关。在任何一组胎儿中均未观察到性别差异。这些发现表明胎儿瘦素浓度与胎儿脂肪量之间存在明确关系。严重IUGR的数据表明存在与胎儿窘迫宫内迹象相关的瘦素浓度升高。
