Kajantie Eero, Kaaja Risto, Ylikorkala Olavi, Andersson Sture, Laivuori Hannele
Hospital of Children and Adolescents and Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Finland.
J Soc Gynecol Investig. 2005 Sep;12(6):433-9. doi: 10.1016/j.jsgi.2005.04.006.
Adiponectin is an adipocyte-derived protein with profound insulin-sensitizing, anti-inflammatory, and antiatherogenic effects. Surprisingly, recent evidence suggests that adiponectin concentrations are increased during preeclampsia, which is characterized by insulin resistance. We studied whether serum adiponectin is related to insulin sensitivity in preeclamptic and normotensive pregnant women.
We measured serum adiponectin concentrations and insulin sensitivity (intravenous glucose tolerance test/minimal model) in 22 women with preeclampsia and 15 normotensive controls with similar pre-pregnancy body mass index (BMI) (range 18-29 kg/m(2)) between 29 and 39 weeks of gestation. Fourteen cases and 10 controls were also studied 6-22 weeks after delivery. No subject had gestational diabetes.
During pregnancy, the mean adiponectin concentration in preeclamptic women was 10.3 (SD 4.2) mug/mL as compared to 7.9 (SD 2.9) microg/mL in normotensive controls (95% confidence interval [CI] for difference 0.1-5.3 microg/mL; P = .04). Adiponectin concentrations were unrelated to insulin sensitivity both in preeclamptic and normotensive subjects; insulin sensitivity was decreased in preeclampsia (P = .01). After delivery, mean adiponectin concentration was lower than during pregnancy: 7.4 (SD 3.0) microg/mL in preeclamptic subjects (P = .001) and 7.1 (SD 1.6) microg/mL in normotensive controls (P = .06) and similar in cases and controls (95% CI for difference -1.7-2.3 microg/mL, P = .7).
Despite their reduced insulin sensitivity, preeclamptic women have higher adiponectin concentrations than normotensive pregnant women. These concentrations are unrelated to insulin sensitivity. After pregnancy, the difference in adiponectin concentrations is no longer present between the two groups. These findings are consistent with a role of adiponectin in the pathophysiology of preeclampsia.
脂联素是一种由脂肪细胞分泌的蛋白质，具有显著的胰岛素增敏、抗炎和抗动脉粥样硬化作用。令人惊讶的是，最近有证据表明，子痫前期患者的脂联素浓度会升高，而子痫前期的特征是胰岛素抵抗。我们研究了子痫前期和血压正常的孕妇血清脂联素水平与胰岛素敏感性之间的关系。
我们测量了22例子痫前期孕妇和15例血压正常的对照组孕妇（孕前体重指数[BMI]相似，范围为18 - 29 kg/m²）在妊娠29至39周时的血清脂联素浓度和胰岛素敏感性（静脉葡萄糖耐量试验/最小模型）。还对14例病例和10例对照在产后6 - 22周进行了研究。所有受试者均无妊娠期糖尿病。
孕期子痫前期孕妇的平均脂联素浓度为10.3（标准差4.2）μg/mL，而血压正常的对照组为7.9（标准差2.9）μg/mL（差异的95%置信区间[CI]为0.1 - 5.3 μg/mL；P = 0.04）。子痫前期和血压正常的受试者中，脂联素浓度与胰岛素敏感性均无关；子痫前期患者的胰岛素敏感性降低（P = 0.01）。产后，子痫前期患者的平均脂联素浓度低于孕期：子痫前期患者为7.4（标准差3.0）μg/mL（P = 0.001），血压正常的对照组为7.1（标准差1.6）μg/mL（P = 0.06），病例组和对照组相似（差异的95% CI为 - 1.7 - 2.3 μg/mL，P = 0.7）。
尽管子痫前期孕妇胰岛素敏感性降低，但与血压正常的孕妇相比，其脂联素浓度更高。这些浓度与胰岛素敏感性无关。产后，两组之间脂联素浓度的差异不再存在。这些发现与脂联素在子痫前期病理生理学中的作用一致。
