Obstetrics and Gynecology Clinic, University Clinical Center of Serbia, Belgrade, Serbia.
Endocr Res. 2012;37(2):78-88. doi: 10.3109/07435800.2011.639319.
The aim of this study was to prospectively evaluate plasma kisspeptin levels in 129 singleton pregnancies with diabetes [pregestational insulin-dependent diabetes mellitus (type 1) and gestational diabetes (GD)] and hypertensive disease [chronic hypertension (CH), gestational hypertension, and preeclampsia (PE)] as a potential marker of placental dysfunction and adverse perinatal outcome.
Kisspeptin levels were evaluated in the first, second, and third trimesters in patients with type 1 diabetes (16 patients), H (22), and healthy control (25) and in the second and third trimesters in patients with GD (20), gestational hypertension (18), and PE (28). Maternal kisspeptin levels were correlated with pregnancy outcome, parameters of fetoplacental circulation, ultrasound-detected abnormalities of placental morphology, and placental weight at delivery.
In pregnancies with type 1 diabetes and H, mean kisspeptin levels were significantly lower compared with the control group (p<0.001 in the first and second trimesters and p<0.05 in the third trimester). Decreased plasma kisspeptin levels in the second and third trimesters were found in patients with GD (p<0.001 in the second and third trimesters) and PE (p<0.001 in the second trimester and p<0.05 in the third trimester). In patients with PE and placental dysfunction, low kisspeptin levels in the third trimester were associated with adverse perinatal outcome.
Our study demonstrates reduced kisspeptin levels in pregnancies with diabetes, H, PE, and placental dysfunction. In patients with PE and placental dysfunction, decreased kisspeptin levels were associated with adverse perinatal outcome. Larger studies are needed to investigate the role of kisspeptin as a potential marker of placental dysfunction and adverse perinatal outcome.
本研究旨在前瞻性评估 129 例单胎妊娠的血浆 kisspeptin 水平，这些妊娠包括糖尿病（孕前胰岛素依赖型糖尿病 [1 型] 和妊娠期糖尿病 [GD]）和高血压疾病（慢性高血压 [CH]、妊娠期高血压和子痫前期 [PE]），以作为胎盘功能障碍和不良围产结局的潜在标志物。
在 1 型糖尿病患者（16 例）、H 患者（22 例）和健康对照组（25 例）的第一、二和三个月以及 GD 患者（20 例）、妊娠期高血压患者（18 例）和 PE 患者（28 例）的第二和第三个月评估 kisspeptin 水平。将母体 kisspeptin 水平与妊娠结局、胎儿胎盘循环参数、胎盘形态超声检测异常以及分娩时胎盘重量相关联。
在 1 型糖尿病和 H 妊娠中，与对照组相比，平均 kisspeptin 水平显著降低（第一和第二个三个月时均为 p<0.001，第三个三个月时为 p<0.05）。在 GD 患者（第二和第三个三个月时均为 p<0.001）和 PE 患者（第二个三个月时为 p<0.001，第三个三个月时为 p<0.05）中发现第二和第三个三个月的血浆 kisspeptin 水平降低。在患有 PE 和胎盘功能障碍的患者中，第三个三个月的低 kisspeptin 水平与不良围产结局相关。
本研究表明，糖尿病、H、PE 和胎盘功能障碍的妊娠中 kisspeptin 水平降低。在患有 PE 和胎盘功能障碍的患者中，降低的 kisspeptin 水平与不良围产结局相关。需要进行更大规模的研究来探讨 kisspeptin 作为胎盘功能障碍和不良围产结局的潜在标志物的作用。
