UCD Obstetrics and Gynecology, School of Medicine and Medical Science, University College Dublin, National Maternity Hospital, Dublin, Ireland.
Int J Gynaecol Obstet. 2013 Feb;120(2):169-72. doi: 10.1016/j.ijgo.2012.08.025. Epub 2012 Nov 28.
To compare maternal and fetal leptin among women without diabetes, women with type 1 diabetes, and women with type 2 diabetes.
In a prospective study at the National Maternity Hospital, Dublin, 40 women with type 1 diabetes, 10 with type 2 diabetes, and 30 without diabetes were enrolled between July 2006 and July 2008. Maternal (36-week) and cord blood leptin was measured by enzyme-linked immunoassay.
No difference was found in maternal leptin among the groups: without diabetes (mean, range): 325 pg/mL, 36-1492 pg/mL; type 1 diabetes: 343.2 pg/mL, 55.5-1108.2 pg/mL; type 2 diabetes: 202.2 pg/mL, 35.1-1553.3 pg/mL (P>0.05). Leptin levels were higher among fetuses of women with type 1 (223 pg/mL, 25.7-810 pg/mL) and type 2 (447.2 pg/mL, 136.3-679 pg/mL) diabetes than among women without diabetes (80.3 pg/mL, 27.3-623.1 pg/mL; P<0.05). The single significant predictor of fetal leptin for the whole cohort was maternal body mass index (BMI; r=0.39, P=0.01). Only third-trimester glycosylated hemoglobin (HbA1c) was significantly related to fetal leptin after controlling for maternal BMI among women with diabetes (r=0.28, P=0.04).
Fetuses of women with diabetes might have some degree of leptin resistance. This might be important in appetite regulation in extrauterine life.
比较无糖尿病、1 型糖尿病和 2 型糖尿病孕妇及其胎儿的瘦素水平。
本前瞻性研究于 2006 年 7 月至 2008 年 7 月在都柏林国立妇产医院进行，纳入了 40 例 1 型糖尿病孕妇、10 例 2 型糖尿病孕妇和 30 例非糖尿病孕妇。采用酶联免疫吸附试验测定孕妇（36 周时）和脐血瘦素水平。
无糖尿病组、1 型糖尿病组和 2 型糖尿病组孕妇瘦素水平无差异：无糖尿病组：325 pg/mL（范围：36-1492 pg/mL）；1 型糖尿病组：343.2 pg/mL（范围：55.5-1108.2 pg/mL）；2 型糖尿病组：202.2 pg/mL（范围：35.1-1553.3 pg/mL）（P>0.05）。1 型糖尿病（223 pg/mL，范围：25.7-810 pg/mL）和 2 型糖尿病（447.2 pg/mL，范围：136.3-679 pg/mL）孕妇的胎儿瘦素水平高于无糖尿病孕妇（80.3 pg/mL，范围：27.3-623.1 pg/mL；P<0.05）。对整个队列进行多元线性回归分析，结果显示母亲的体重指数（BMI）是胎儿瘦素水平的唯一显著预测因子（r=0.39，P=0.01）。在校正了糖尿病孕妇的 BMI 后，仅发现孕期糖化血红蛋白（HbA1c）与胎儿瘦素呈正相关（r=0.28，P=0.04）。
糖尿病孕妇的胎儿可能存在一定程度的瘦素抵抗。这可能对胎儿出生后的食欲调节具有重要意义。
