血清瘦素与肥胖相关，但在妊娠 24-28 周时并不区分妊娠期糖尿病和正常糖耐量。
Serum Leptin Correlates with Obesity But Does Not Differ Between Gestational Diabetes and Normal Glucose Tolerance during 24-28 Weeks of Gestation.
机构信息
Dr Choman Abdullah Mohana, Medical Officer, Mymensingh Medical College Hospital, Mymensingh, Bangladesh; E-mail:
出版信息
Mymensingh Med J. 2022 Apr;31(2):318-325.
Leptin is an adipocytokine secreted by adipocytes which positively correlates with obesity. It is considered as a potential mediator for precipitating Gestational diabetes mellitus (GDM) which is more evident during 24-28 weeks of gestation. This study was conducted to see serum leptin level during 24-28 weeks of gestation in GDM at the Department of Endocrinology, BSMMU, Bangladesh from March 2019 to August 2020. Pregnant women (N=108) were challenged with 75gm oral glucose (OGTT) at 24-28 weeks of gestation and divided into GDM [n=45, age: 27.80±3.98 years, mean±SD; BMI: 27.88 (24.46-30.43) kg/m², median Interquartile range (IQR)] and normal glucose tolerance [NGT; n=62, age: 26.19±5.30 years, mean±SD; BMI: 25.80 (23.65-28.42) kg/m², median (IQR)] on basis of WHO-2013 diagnostic criteria. Fasting serum leptin and glucose were measured by ELISA and glucose oxidase method respectively. No statistically significant difference was found between GDM and NGT for leptin [26.05(16.92-50.55) vs. 23.50(14.95-38.30) median (IQR), p=0.360]. It was also not different statistically between GDM and NGT either for age groups (p=NS for all) or for Asian categories of BMI subgroups (p=NS for all). However, it was higher in subjects with BMI ≥23kg/m² than that with BMI ≤23kg/m² for both GDM [16.65 (6.39, 35.75) vs. 28.35 (19.60, 51.10) median (IQR), p=0.114] and NGT [14.65(9.19, 19.60) vs. 26.00 (17.30, 43.40) median (IQR), p=0.002]. It was also statistically similar in the GDM subgroups divided by Asian BMI cut-off (p=NS). BMI correlated with leptin in NGT (r=0.495, p<0.001) but not in GDM (r=0.177, p=0.251) and regression analysis revealed BMI (kg/m²) as predictor for high leptin (p=0.008). ROC curve analysis for leptin showed AUC for GDM was 0.553 (p=0.360) suggesting it as a poor predictor. It is concluded that fasting leptin in 24-28 weeks of gestation better relates with BMI but does not differ between GDM and NGT anddoes not seem to be a good predictor for GDM. Further study is required to make a comment on its prediction over GDM.
瘦素是一种由脂肪细胞分泌的脂肪细胞因子，与肥胖呈正相关。它被认为是引发妊娠糖尿病（GDM）的潜在介质，在妊娠 24-28 周时更为明显。本研究旨在探讨孟加拉国 BSMMU 内分泌科在 2019 年 3 月至 2020 年 8 月期间，24-28 周时 GDM 患者血清瘦素水平。对 108 名孕妇进行 75g 口服葡萄糖耐量试验（OGTT），并根据世界卫生组织 2013 年的诊断标准分为 GDM [n=45，年龄：27.80±3.98 岁，均值±标准差；BMI：27.88（24.46-30.43）kg/m²，中位数四分位距（IQR）]和正常糖耐量 [NGT；n=62，年龄：26.19±5.30 岁，均值±标准差；BMI：25.80（23.65-28.42）kg/m²，中位数（IQR）]。采用 ELISA 和葡萄糖氧化酶法分别检测空腹血清瘦素和血糖。GDM 和 NGT 组的瘦素水平[26.05（16.92-50.55）vs. 23.50（14.95-38.30）中位数（IQR），p=0.360]无统计学差异。在年龄组（p=NS 所有）或亚洲 BMI 亚组的亚洲类别（p=NS 所有）中，GDM 和 NGT 之间的瘦素水平也无统计学差异。然而，在 BMI≥23kg/m²的受试者中，瘦素水平高于 BMI≤23kg/m²的受试者[16.65（6.39，35.75）vs. 28.35（19.60，51.10）中位数（IQR），p=0.114]，NGT 也如此[14.65（9.19，19.60）vs. 26.00（17.30，43.40）中位数（IQR），p=0.002]。根据亚洲 BMI 切点对 GDM 进行分组后，瘦素水平也无统计学差异（p=NS）。在 NGT 中，BMI 与瘦素呈正相关（r=0.495，p<0.001），但在 GDM 中不相关（r=0.177，p=0.251），回归分析显示 BMI（kg/m²）是高瘦素的预测因子（p=0.008）。ROC 曲线分析显示 GDM 的 AUC 为 0.553（p=0.360），表明其为较差的预测因子。综上所述，24-28 周时的空腹瘦素与 BMI 相关性更好，但 GDM 和 NGT 之间无差异，似乎不是 GDM 的良好预测因子。需要进一步研究以评价其对 GDM 的预测作用。
Zotero 插件