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Cord Blood Leptin Levels in Gestational Diabetes

机译：妊娠期糖尿病患者的脐血瘦素水平

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OBJECTIVE: To evaluate the cord leptin levels of newborns in relation to birthweight and Gestational?Diabetes (GD) either regulated by insulin or diet. STUDY DESIGN: A total of 62 patients were included in the study. Patients with impaired oral glucose?tolerance test were included with diagnosis of GD (n=41). Control group consisted of women with normal?plasma glucose level and 50-gr oral glucose challenge test (n=21). Twenty six of women with GD?had blood glucose control by diet, while 15 required insulin. The blood samples were taken from the umblical?cord of the newborns of GD and the control group for leptin levels. RESULTS: Birthweight of babies born to healthy mothers, mothers with GD regulated by diet and insulin?were 3197.14±348.2 gr, 3496.11±734.9 gr and 3642.86±843.8 gr, respectively (p=0.05). Percentages of?macrosomic babies were 4.8%, 11.5% and 33.3% in healthy women, women with GD regulated by diet?and insulin, respectively (p0.05). ). Cord blood leptin levels were higher in women with GD requiring insulin (6.1 ng/ml, range: 0.48-28.5) compared to women with GD regulated by diet (2.7 ng/ml, range: 0.5-54.7) and healthy mothers (2.0 ng/ml, range: 0.2-6.4, p0.05). Cord blood leptin level was positively correlated?with BMI (r:0.44, p0.01), weight of mother (r:0.43, p0.01), birthweight (r:0.37, p0.05), and?presence of GD and necessity of insulin (r:0.41, p0.01).Cord blood leptin level was the only factor defining?maternal GD requiring insulin in ROC analysis (AUC:0.77, p0.01). Cord blood leptin level equal to?or higher than 4.1 ng/ml had a sensitivity of 80% and specificity of 79% in defining GD with insulin requirement?(positive likelihood ratio:3.68) CONCLUSION: In this study there is a minimal clinical effect of cord blood leptin on macrosomia in?women with GD, although it is increased in GD and associated with birthweight. Therefore overgrowth?may be a result of direct anabolic effect of insulin, rather than indirect effect via leptin.
机译：目的：评估胰岛素或饮食调节的新生儿脐带瘦素水平与体重和妊娠期糖尿病（GD）的关系。研究设计：总共62例患者被纳入研究。口服葡萄糖耐量测试受损的患者被纳入诊断为GD（n = 41）。对照组包括血浆葡萄糖水平正常且口服葡萄糖激发试验为50-gr的妇女（n = 21）。 GD？的26位女性通过饮食控制血糖，而15位需要胰岛素。血样取自GD新生儿脐带和对照组的瘦素水平。结果：健康母亲，受饮食和胰岛素调节的GD母亲的出生体重分别为3197.14±348.2 gr，3496.11±734.9 gr和3642.86±843.8 gr（p = 0.05）。健康女性，受饮食和胰岛素调节的GD女性中，大染色体婴儿的百分比分别为4.8％，11.5％和33.3％（p <0.05）。 ）。 GD需要胰岛素的女性（6.1 ng / ml，范围：0.48-28.5）的脐血瘦素水平高于受饮食调节的GD（2.7 ng / ml，范围：0.5-54.7）和健康母亲（2.0 ng）的脐带血瘦素水平。 / ml，范围：0.2-6.4，p ＜0.05）。脐血瘦素水平与BMI（r：0.44，p <0.01），母亲的体重（r：0.43，p <0.01），出生体重（r：0.37，p <0.05），GD的存在和正相关。胰岛素的必要性（r：0.41，p <0.01）。血液中瘦素水平是定义ROC分析中需要胰岛素的母体GD的唯一因素（AUC：0.77，p <0.01）。等于或高于4.1 ng / ml的脐血瘦素水平在确定GD与胰岛素需求时的敏感性为80％，特异性为79％？（阳性可能性比：3.68）结论：本研究对临床的影响很小脐血瘦素对GD患儿的巨大儿的影响，尽管GD升高且与出生体重有关。因此，过度生长可能是胰岛素直接合成代谢作用的结果，而不是瘦素间接作用的结果。

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