Franco-Sena Ana Beatriz, de Oliveira Livia Costa, de Jesus Pereira Pinto Thatiana, Farias Dayana Rodrigues, Vaz Juliana dos Santos, Kac Gilberto
Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil; Graduate Program in Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil.
Clin Endocrinol (Oxf). 2015 Jan;82(1):127-35. doi: 10.1111/cen.12487. Epub 2014 Jun 21.
Leptin concentrations increase throughout pregnancy but little is known about factors that influence this physiological change and whether they differ according to pregestational body mass index (BMI).
To assess whether longitudinal trends of leptin in pregnancy are influenced by biochemical, anthropometric and lifestyle factors in women with normal weight (NW), overweight (OW) or obese (OB) pregestational BMI.
Prospective cohort of 232 pregnant women followed at 5-13th, 20-26th and 30-36th gestational weeks. The effect of selected variables on longitudinal behaviour of plasma leptin concentrations, stratifying for NW (18·5-24·9 kg/m(2) ), OW (25-29·9 kg/m(2) ) and OB (≥30·0 kg/m(2) ) pregestational BMI was assessed through longitudinal linear mixed-effects models.
The multiple regression model for women with NW revealed associations of maternal body weight (β = 0·714, CI = 0·491 to 0·937), serum HDL-cholesterol (β = 0·239, CI =0·089 to 0·388) and C-reactive protein (CRP) (β = -0·138, CI = -0·272 to -0·004) with plasma leptin concentrations. Maternal body weight (β = -0·871, CI = 0·475 to 1·267) and serum HDL-cholesterol concentrations (β = 0·315, CI = -0·022 to 0·651) were also associated with leptin in OW women. In OB women, serum HDL-cholesterol (β = 0·722, CI = 0·219 to 1·226), maternal body weight (β = 0·666, CI = 0·187 to 1·145), triglycerides concentrations (β = -0·130, CI = -0·241 to -0·020) and dietary carbohydrate (β = 0·075, CI = 0·023 to 0·126) were significantly associated with plasma leptin.
Maternal body weight and serum concentrations of HDL-cholesterol were associated with leptin changes independent of pregestational BMI. Serum CRP concentrations were associated with leptin only in NW women and serum triglycerides concentrations and dietary carbohydrate only in OB. These results indicate that factors that influence leptin concentrations differ according to pregestational BMI.
孕期瘦素浓度会升高，但对于影响这一生理变化的因素以及这些因素是否因孕前体重指数（BMI）不同而存在差异，我们知之甚少。
评估孕前BMI正常（NW）、超重（OW）或肥胖（OB）的孕妇，其孕期瘦素的纵向变化趋势是否受生化、人体测量和生活方式因素的影响。
对232名孕妇进行前瞻性队列研究，在妊娠第5 - 13周、20 - 26周和30 - 36周进行随访。通过纵向线性混合效应模型，评估所选变量对血浆瘦素浓度纵向变化的影响，并根据孕前BMI将孕妇分为NW组（18.5 - 24.9kg/m²）、OW组（25 - 29.9kg/m²）和OB组（≥30.0kg/m²）。
NW组女性的多元回归模型显示，孕妇体重（β = 0.714，CI = 0.491至0.937）、血清高密度脂蛋白胆固醇（HDL - 胆固醇）（β = 0.239，CI = 0.089至0.388）和C反应蛋白（CRP）（β = -0.138，CI = -0.272至 -0.004）与血浆瘦素浓度相关。OW组女性中，孕妇体重（β = -0.871，CI = 0.475至1.267）和血清HDL - 胆固醇浓度（β = 0.315，CI = -0.022至0.651）也与瘦素相关。在OB组女性中，血清HDL - 胆固醇（β = 0.722，CI = 0.219至1.226）、孕妇体重（β = 0.666，CI = 0.187至1.145）、甘油三酯浓度（β = -0.130，CI = -0.241至 -0.020）和膳食碳水化合物（β = 0.075，CI = 0.023至0.126）与血浆瘦素显著相关。
孕妇体重和血清HDL - 胆固醇浓度与瘦素变化相关，且不受孕前BMI影响。血清CRP浓度仅在NW组女性中与瘦素相关，血清甘油三酯浓度和膳食碳水化合物仅在OB组女性中与瘦素相关。这些结果表明，影响瘦素浓度的因素因孕前BMI不同而存在差异。
