Roca-Rodríguez María Del Mar, Ramos-García Pablo, López-Tinoco Cristina, Aguilar-Diosdado Manuel
Department of Endocrinology and Nutrition and Biomedical Research and Innovation Institute of Cadiz (INiBICA), Puerta del Mar University Hospital, 11009 Cadiz, Spain.
Department of Oral Medicine, School of Dentistry, University of Granada, 18071 Granada, Spain.
J Clin Med. 2022 Apr 26;11(9):2433. doi: 10.3390/jcm11092433.
Gestational diabetes mellitus (GDM) represents a stage of subclinical inflammation and a risk factor for subsequent future type 2 diabetes and cardiovascular disease development. Leptin has been related with vascular and metabolic changes in GDM with heterogeneous and contradictory results with respect to their possible involvement in maternal, perinatal, and future complications. Our objective is to evaluate current evidence on the role of leptin in maternal and perinatal complications in women with GDM. PubMed, Embase, Web of Science, and Scopus databases were searched. We evaluated the studies’ quality using the Newcastle-Ottawa scale. Meta-analyses were conducted, and heterogeneity and publication bias were examined. Thirty-nine relevant studies were finally included, recruiting 2255 GDM and 3846 control pregnant women. Leptin levels were significantly higher in GDM participants than in controls (SMD = 0.57, 95%CI = 0.19 to 0.94; p < 0.001). Subgroup meta-analysis did not evidence significant differences in leptin in the different trimesters of pregnancy. Meta-regression showed a positive significant relationship for HOMA in the GDM group (p = 0.05). According to these results, it seems that high levels of leptin can be used as predictive markers in GDM.
妊娠期糖尿病(GDM)代表亚临床炎症阶段,是后续发生2型糖尿病和心血管疾病的危险因素。瘦素与GDM中的血管和代谢变化有关,但其在母体、围产期及未来并发症中的可能作用结果存在异质性且相互矛盾。我们的目的是评估当前关于瘦素在GDM女性母体和围产期并发症中作用的证据。检索了PubMed、Embase、科学网和Scopus数据库。我们使用纽卡斯尔-渥太华量表评估研究质量。进行了荟萃分析,并检查了异质性和发表偏倚。最终纳入39项相关研究,招募了2255名GDM孕妇和3846名对照孕妇。GDM参与者的瘦素水平显著高于对照组(标准化均数差=0.57,95%置信区间=0.19至0.94;p<0.001)。亚组荟萃分析未显示妊娠不同孕周瘦素水平存在显著差异。荟萃回归显示GDM组中HOMA呈显著正相关(p=0.05)。根据这些结果,似乎高水平的瘦素可作为GDM的预测标志物。