Sarcouncil Journal of Medical Series

Abstract: Background: Leptin, a pleiotropic adipokine tic metabolic and angiogenic hormone, is known to increase in the course of pregnancy. Its exact contribution and control in pathological pregnancies like gestational diabetes mellitus (GDM) and preeclampsia (PE) are yet to be completely clarified, especially when the confounding effect of maternal adiposity is factored in. Aim: The aim of the research was to compare maternal serum leptin levels in normal pregnancies and those complicated by GDM or preeclampsia, as well as to examine the relationship between hyperleptinemia and the pathological conditions, taking into account the impact of pre-pregnancy body mass index (BMI). Methodology: It was a cross-sectional study that was carried out on 70 pregnant women at their 3rd trimester (28-36 gestation). The sample was divided into three samples and groups: uncomplicated pregnancy (n=30), GDM (n=20), and PE (n=20). The level of leptin in the maternal serum was assessed, and the level of 25 ng/ml was considered to be high level of leptin. Demographic and clinical data was obtained, and statistical analyses were done in terms of group comparisons and Pearson correlation tests. Results Summary: The normal pregnancy group has a mean serum leptin level of 21.4 ± 7.2 ng/mL, that is lower than the GDM (28.9 ± 8.5 ng/mL) and PE (33.5 ± 10.1 ng/mL) groups. Hyperleptinemia was significantly higher overall in pathological pregnancies (52.5%) compared to normal controls (20.0%). Although pre-pregnancy BMI was a positive and significant correlate of leptin levels in all groups (r=0.76 in GDM, r=0.72 in PE), there was a higher proportion of high leptin levels in the pathological pregnancy groups in each of the BMI stratum. Also, leptin levels were strongly correlated with fasting insulin and HOMA-IR (r=0.71 and r=0.68, respectively) in the GDM group, and systolic BP, diastolic BP, and proteinuria (r=0.48, r=0.51, and r=0.59, respectively) in the PE group. Conclusion: We have shown that hyperleptinemia is strongly correlated with pathological pregnancies, namely, GDM and preeclampsia. Maternal BMI is one of the key factors leading to leptin levels, but the independent increase in these complications indicates that there is a likelihood of the pathophysiological effect of leptin, associated with insulin resistance in GDM and endothelial dysfunction in PE. Leptin has the potential to become a useful biomarker and should be considered as a potential therapeutic target.