Department of Obstetrics and Gynaecology. Tzaneio General Hospital, Pireaus, Greece.
Gynecol Endocrinol. 2010 May;26(5):338-43. doi: 10.3109/09513590903511463.
We measured first trimester plasma leptin concentrations in 37 women who subsequently developed pre-eclampsia and 53 normotensive controls to determine the interrelation between leptin and body mass index (BMI) in both groups. We further investigated the association between the risks for pre-eclampsia with maternal leptin levels.
Bloods samples were collected at 13 weeks. Non-parametric tests, Spearman's correlation, linear regression analysis and multiple logistic regression analysis were applied in our data.
1 kg/m(2) increase in pre-pregnancy BMI was related to a 2.747 (95% CI: 3.242-2.252) ng/ml rise in leptin concentration among cases and 2.502 (95% CI: 2.873-2.131) ng/ml rise in leptin concentrations among controls. Increased leptin concentration (>or=25.3 ng/ml ) in lean women is associated with a 18.8-fold increased risk of pre-eclampsia (adjusted OR: 18.8, CI: 1.8-194, p = 0.014 ). Leptin treated as a continuous variable is a significant predictor of pre-eclampsia (adjusted OR: 1.08, CI: 1.018-1.133, p = 0.009).
Increased leptin concentration can definitely contribute to the prediction of pre-eclampsia in lean women, but this is not the case in overweight women. Further research in terms of longitudinal case-control studies is required to clarify the predictive value of pre-eclampsia.
我们测量了 37 名随后发生子痫前期的妇女和 53 名正常血压对照者的妊娠早期血浆瘦素浓度,以确定两组中瘦素与体重指数(BMI)之间的相互关系。我们进一步研究了母体瘦素水平与子痫前期风险之间的关系。
在 13 周时采集血样。我们在数据中应用了非参数检验、Spearman 相关分析、线性回归分析和多因素逻辑回归分析。
妊娠前 BMI 每增加 1kg/m²,病例组的瘦素浓度升高 2.747(95%CI:3.242-2.252)ng/ml,对照组升高 2.502(95%CI:2.873-2.131)ng/ml。瘦素浓度升高(≥25.3ng/ml)的瘦体型妇女子痫前期的风险增加 18.8 倍(调整后的 OR:18.8,CI:1.8-194,p=0.014)。将瘦素作为连续变量处理,是子痫前期的显著预测因子(调整后的 OR:1.08,CI:1.018-1.133,p=0.009)。
瘦素浓度的升高确实有助于预测瘦体型妇女的子痫前期,但在超重妇女中并非如此。需要进一步进行前瞻性病例对照研究以阐明子痫前期的预测价值。