| Abstrakt: |
Gestational diabetes mellitus (GDM) is the most common pregnancy complication, in which women without previously diagnosed diabetes develop hyperglycemia during gestation. This hyperglycemia usually results from impaired glucose tolerance due to pancreatic β-cell dysfunction and increased the insulin resistance. Leptin hormone is a protein secreted by white adipocytes and it plays a significant role in the regulation of body weight and food intake. Leptin acts in an autocrine/paracrine fashion in the placenta and adipose tissue in pregnancy and thus playing a role in the maternal-fetal line and additional important role in glucose metabolism and fetal development. The aim of the study on leptin level and its effect on insulin level in pregnancies complicated by gestational diabetes mellitus (GDM) and also on type1 diabetes mellitus. A study on the distinct alterations in body weight and glucose metabolism as well as insulin resistance and their effects on leptin levels in both GDM and type 1 DM. Leptin level, BMI, C-peptide, HbA1c and lipid profile were measured in 75 control non-diabetic pregnant women, 75 gestational diabetes mellitus and 40 type1 diabetes mellitus. Blood samples were collected from pregnant women at 24-38 weeks of gestation. Correlation measured between leptin level with BMI, c-peptide and lipid profile. The average levels of both leptin and c-peptide were found to be significantly higher in GDM (21.09±2.43 ng/ml and 5.88±0.62 ng/ml respectively) as compared to control (4.97±0.78ng/ml and 17.47±1.86 ng/ml, respectively). This increasement was statically significant for both c-peptide (P=0.05) and leptin (P=0.017). In contrast, both serum c-peptide and leptin levels were lower in pregnant women with type1 DM than in control (0.03±0.004 ng/ml vs. 4.97±0.78ng/ml and 13.33±2.35ng/ml vs. 17.47±1.86 ng/ml, respectively). These changes were significant (P-value = 0.000, p-value = 0.038). The Pearson correlation test showed a significant positive correlation of BMI with leptin of healthy pregnant women and pregnant women with GDM (P-value = 0.000 and P-value = 0.02, respectively). The Pearson correlation test showed a significant positive correlation of BMI with triglycerides of type1 DM (P-value=0.000). The Pearson correlation test showed a significant positive correlations of c-peptide with leptin in healthy pregnant women (P=0.003). In conclusion, serum leptin and c-peptide levels were increased in pregnant women with GDM compared to healthy pregnancies. Leptin and c-peptide levels were decreased in pregnant women with type 1 DM as compared to healthy pregnant women. The elevation of leptin level was significant in pregnant women with GDM during the second and third trimesters compared to the non-diabetic pregnant women. This increasing in leptin level in pregnant women with GDM was due to increase insulin resistance and hyperinsulinemia in gestational diabetes mellitus. Also, there was a positive correlation of leptin level with BMI. [ABSTRACT FROM AUTHOR] |
