Bomba-Opon Dorota A, Horosz Edyta, Szymanska Monika, Wielgos Miroslaw
1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland.
Neuro Endocrinol Lett. 2010;31(4):568-72.
Maternal insulin sensitivity have strong correlation with fetal growth. The dysregulation of adiponectin and leptin is found in insulin resistance. The aim of this study was to determine whether there is an association between ultrasound fetal biometry and the maternal plasma cytokines and insulin concentrations at the beginning of gestational diabetes treatment.
121 women with gestational diabetes diagnosed between 26th and 30th weeks, were included to the study. Plasma levels of adiponectin, leptin, insulin and glucose were quantified with the measurements and percentiles of the biparietal diameter, head circumference and abdominal circumference , estimated fetal weight and the actual birthweight.
Associations between both of the adipokines and fetal biometry measurements were not evident. There were also no differences in their serum concentrations between groups of women with and without accelerated fetal growth . Adiponectin negatively correlated with pre-pregnancy BMI (r=-0.366, p=0.01). Leptin positively correlated with pre - pregnancy BMI (r=0.42, p=0.002), fasting insulin (r=0.51, p=0.0006) and HOMA-IR (r=0.43, p=0.005). No association was found between adiponectin, leptin, fasting insulin, HOMA-IR and neonatal birth weight or birth weight percentile.
The results of this study imply that adiponectin, leptin and insulin maternal plasma concentrations in the third trimester do not have influence on fetal growth in gestational diabetes.
母体胰岛素敏感性与胎儿生长密切相关。脂联素和瘦素的失调存在于胰岛素抵抗中。本研究的目的是确定在妊娠糖尿病治疗开始时，超声胎儿生物测量与母体血浆细胞因子和胰岛素浓度之间是否存在关联。
纳入121例在孕26至30周诊断为妊娠糖尿病的妇女。通过测量双顶径、头围、腹围、估计胎儿体重和实际出生体重的百分位数，对血浆脂联素、瘦素、胰岛素和葡萄糖水平进行定量分析。
两种脂肪因子与胎儿生物测量之间的关联均不明显。胎儿生长加速和未加速的两组女性血清浓度也无差异。脂联素与孕前BMI呈负相关（r = -0.366，p = 0.01）。瘦素与孕前BMI呈正相关（r = 0.42，p = 0.002）、空腹胰岛素（r = 0.51，p = 0.0006）和HOMA-IR（r = 0.43，p = 0.005）。未发现脂联素、瘦素、空腹胰岛素、HOMA-IR与新生儿出生体重或出生体重百分位数之间存在关联。
本研究结果表明，妊娠晚期母体血浆中脂联素、瘦素和胰岛素浓度对妊娠糖尿病胎儿生长无影响。
