Serum leptin can be a predictable marker for gestational diabetes mellitus: IJOGR
Gestational Diabetes Mellitus (GDM) is one of the most
prevalent conditions associated with pregnancy, and if untreated it can have a
major negative impact on both the mother’s and the child’s health. It affects
3-8% of pregnancies and is defined by glucose intolerance identified during
pregnancy due to obesity risk. The etiology of GDM remains poorly understood.
The most widely accepted explanation states that human placental lactogen,
prolactin, glucocorticoids, and progesterone all of which are released by the
placenta during pregnancy cause GDM by lowering insulin sensitivity and boosting
anti-insulin hormones. Adipocytes produce adipocytokines likes leptin that
contribute to energy balance, metabolism of glucose and insulin. According to
certain research, leptin may also play a major role in controlling the body’s
overall glucose homeostasis. Leptin may therefore play a significant role in the
onset and prognosis of GDM. There is a favorable relationship between plasma
leptin concentrations and both direct and indirect markers of obesity. Leptin
levels rise in expectant mothers who have altered maternal fat reserves and
glucose metabolism. The concentration of leptin in mothers rises two to three
times higher than in non-pregnant women, peaking at 28 weeks of gestation.
This study assessed the serum leptin concentrations for
development of gestational diabetes mellitus. It is a case-control study,
included 120 participants (60: Gestational Diabetes Mellitus Cases and 60:
Healthy Controls). Authors assed BMI, FBS, HbA1c, Lipid Profile and serum
leptin. Results: The serum leptin concentrations were significantly elevated in
patients with gestational diabetes mellitus when compared to controls (P=0.001).
There was a significant positive correlation between the serum leptin and BMI,
FBS, HbA1c, Total Cholesterol and LDL (P=0.001).
The current study illustrated how maternal circulating
leptin changes during gestational diabetes mellitus. Several studies have
reported varying patterns of leptin variation with increasing gestational age
in a typical pregnancy. The results of this investigation support the
hypothesis that GDM and the mother’s circulating leptin profile are related. An
adaptive reaction to insulin resistance and the inflammatory response linked to
GDM could account for the variation in circulating leptin concentration
observed in early gestation between women with and without GDM. By directly
regulating the insulin receptor or indirectly through central neuronal
pathways, leptin may enhance insulin sensitivity and it can also directly
promote the absorption of glucose and the synthesis of glycogen in skeletal
muscle.
It was also believed that the upregulation of the leptin
gene and protein production constituted a sort of defense mechanism against the
imbalance of proinflammatory cytokines that occurs in many abnormal
pregnancies, including GDM.
Based on the present study findings, authors concluded that
significant elevated levels of serum leptin might be served as a marker for
detection of gestational diabetes mellitus.
Source: Thilak, Harika and Narayanswamy / Indian Journal of
Obstetrics and Gynecology Research 2024;11(2):198–202
