Maternal Pregravid Weight is the Primary Determinant of Serum Leptin and its Metabolic Associations in Pregnancy, Irrespective of Gestational Glucose Tolerance Status

Louise Maple-Brown, C Ye, Anthony Hanley, Philip Connelly, M Sermer, Bernard Zinman, R Retnakaran

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Abstract

Context: Several previous studies have investigated circulating levels of the adipokine leptin in relation to gestational diabetes mellitus (GDM). However, these studies have yielded markedly conflicting results, including increased, decreased, and unchanged leptin levels in women with GDM as compared with their peers.

Objective: We sought to evaluate the metabolic determinants of serum leptin in a well-characterized cohort reflecting the full spectrum of glucose intolerance in pregnancy.

Design, Setting, and Participants: Metabolic characterization, including oral glucose tolerance test (OGTT) and measurement of serum leptin, insulin, lipids, adiponectin, and C-reactive protein, was performed in 817 pregnant women. The OGTT identified 198 women with GDM, 142 with gestational impaired glucose tolerance, and 477 with normal glucose tolerance.

Results: Median leptin (ng/ml) did not differ between the normal glucose tolerance (33.7), gestational impaired glucose tolerance (36.3), and GDM (36.4) groups (P= 0.085). On univariate correlation analysis, leptin was most strongly associated with prepregnancy body mass index (BMI) (r = 0.54, P < 0.0001), fasting insulin (r = 0.60, P < 0.0001), and C-reactive protein (r = 0.38, P < 0.0001) but only weakly associated with area under the glucose curve (AUCglucose) on the OGTT (r = 0.10, P = 0.0066). On multiple linear regression analysis, the strongest independent determinant of leptin was prepregnancy BMI (t = 11.55, P < 0.0001), whereas AUCglucose was not a significant predictor (t = −0.95, P = 0.34). Furthermore, although its respective associations with fasting insulin, triglycerides, and adiponectin varied across tertiles of prepregnancy BMI, leptin was not significantly associated with AUCglucose in any BMI tertile.

Conclusions: Pregravid BMI, rather than gestational glucose tolerance, is the primary determinant of serum leptin concentration in pregnancy.

Original languageEnglish
Pages (from-to)4148-4155
Number of pages8
JournalJournal of Clinical Endocrinology and Metabolism
Volume97
Issue number11
DOIs
Publication statusPublished - 1 Nov 2012

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Leptin
Mothers
Weights and Measures
Glucose
Pregnancy
Serum
Glucose Intolerance
Glucose Tolerance Test
Adiponectin
Insulin
C-Reactive Protein
Fasting
Adipokines
Area Under Curve
Pregnant Women
Triglycerides
Lipids

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@article{0be6f6a411264bb0bff6a621bfa30616,
title = "Maternal Pregravid Weight is the Primary Determinant of Serum Leptin and its Metabolic Associations in Pregnancy, Irrespective of Gestational Glucose Tolerance Status",
abstract = "Context: Several previous studies have investigated circulating levels of the adipokine leptin in relation to gestational diabetes mellitus (GDM). However, these studies have yielded markedly conflicting results, including increased, decreased, and unchanged leptin levels in women with GDM as compared with their peers. Objective: We sought to evaluate the metabolic determinants of serum leptin in a well-characterized cohort reflecting the full spectrum of glucose intolerance in pregnancy. Design, Setting, and Participants: Metabolic characterization, including oral glucose tolerance test (OGTT) and measurement of serum leptin, insulin, lipids, adiponectin, and C-reactive protein, was performed in 817 pregnant women. The OGTT identified 198 women with GDM, 142 with gestational impaired glucose tolerance, and 477 with normal glucose tolerance. Results: Median leptin (ng/ml) did not differ between the normal glucose tolerance (33.7), gestational impaired glucose tolerance (36.3), and GDM (36.4) groups (P= 0.085). On univariate correlation analysis, leptin was most strongly associated with prepregnancy body mass index (BMI) (r = 0.54, P < 0.0001), fasting insulin (r = 0.60, P < 0.0001), and C-reactive protein (r = 0.38, P < 0.0001) but only weakly associated with area under the glucose curve (AUCglucose) on the OGTT (r = 0.10, P = 0.0066). On multiple linear regression analysis, the strongest independent determinant of leptin was prepregnancy BMI (t = 11.55, P < 0.0001), whereas AUCglucose was not a significant predictor (t = −0.95, P = 0.34). Furthermore, although its respective associations with fasting insulin, triglycerides, and adiponectin varied across tertiles of prepregnancy BMI, leptin was not significantly associated with AUCglucose in any BMI tertile. Conclusions: Pregravid BMI, rather than gestational glucose tolerance, is the primary determinant of serum leptin concentration in pregnancy.",
keywords = "adiponectin, C reactive protein, cholesterol, high density lipoprotein cholesterol, insulin, leptin, triacylglycerol, very low density lipoprotein cholesterol, adult, area under the curve, article, body mass, body weight, disease association, female, glucose intolerance, human, insulin blood level, lipid blood level, multiple linear regression analysis, oral glucose tolerance test, outcome assessment, pregnancy, pregnancy diabetes mellitus, priority journal, protein blood level, univariate analysis, Adiponectin, Adult, Blood Glucose, Body Weight, C-Reactive Protein, Diabetes, Gestational, Female, Glucose Intolerance, Glucose Tolerance Test, Humans, Insulin, Insulin Resistance, Leptin, Lipids, Pregnancy",
author = "Louise Maple-Brown and C Ye and Anthony Hanley and Philip Connelly and M Sermer and Bernard Zinman and R Retnakaran",
year = "2012",
month = "11",
day = "1",
doi = "10.1210/jc.2012-2290",
language = "English",
volume = "97",
pages = "4148--4155",
journal = "Journal of Clinical Endocrinology and Metabolism",
issn = "0021-972X",
publisher = "The Endocrine Society",
number = "11",

}

Maternal Pregravid Weight is the Primary Determinant of Serum Leptin and its Metabolic Associations in Pregnancy, Irrespective of Gestational Glucose Tolerance Status. / Maple-Brown, Louise; Ye, C; Hanley, Anthony; Connelly, Philip; Sermer, M; Zinman, Bernard; Retnakaran, R.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 97, No. 11, 01.11.2012, p. 4148-4155.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Maternal Pregravid Weight is the Primary Determinant of Serum Leptin and its Metabolic Associations in Pregnancy, Irrespective of Gestational Glucose Tolerance Status

AU - Maple-Brown, Louise

AU - Ye, C

AU - Hanley, Anthony

AU - Connelly, Philip

AU - Sermer, M

AU - Zinman, Bernard

AU - Retnakaran, R

PY - 2012/11/1

Y1 - 2012/11/1

N2 - Context: Several previous studies have investigated circulating levels of the adipokine leptin in relation to gestational diabetes mellitus (GDM). However, these studies have yielded markedly conflicting results, including increased, decreased, and unchanged leptin levels in women with GDM as compared with their peers. Objective: We sought to evaluate the metabolic determinants of serum leptin in a well-characterized cohort reflecting the full spectrum of glucose intolerance in pregnancy. Design, Setting, and Participants: Metabolic characterization, including oral glucose tolerance test (OGTT) and measurement of serum leptin, insulin, lipids, adiponectin, and C-reactive protein, was performed in 817 pregnant women. The OGTT identified 198 women with GDM, 142 with gestational impaired glucose tolerance, and 477 with normal glucose tolerance. Results: Median leptin (ng/ml) did not differ between the normal glucose tolerance (33.7), gestational impaired glucose tolerance (36.3), and GDM (36.4) groups (P= 0.085). On univariate correlation analysis, leptin was most strongly associated with prepregnancy body mass index (BMI) (r = 0.54, P < 0.0001), fasting insulin (r = 0.60, P < 0.0001), and C-reactive protein (r = 0.38, P < 0.0001) but only weakly associated with area under the glucose curve (AUCglucose) on the OGTT (r = 0.10, P = 0.0066). On multiple linear regression analysis, the strongest independent determinant of leptin was prepregnancy BMI (t = 11.55, P < 0.0001), whereas AUCglucose was not a significant predictor (t = −0.95, P = 0.34). Furthermore, although its respective associations with fasting insulin, triglycerides, and adiponectin varied across tertiles of prepregnancy BMI, leptin was not significantly associated with AUCglucose in any BMI tertile. Conclusions: Pregravid BMI, rather than gestational glucose tolerance, is the primary determinant of serum leptin concentration in pregnancy.

AB - Context: Several previous studies have investigated circulating levels of the adipokine leptin in relation to gestational diabetes mellitus (GDM). However, these studies have yielded markedly conflicting results, including increased, decreased, and unchanged leptin levels in women with GDM as compared with their peers. Objective: We sought to evaluate the metabolic determinants of serum leptin in a well-characterized cohort reflecting the full spectrum of glucose intolerance in pregnancy. Design, Setting, and Participants: Metabolic characterization, including oral glucose tolerance test (OGTT) and measurement of serum leptin, insulin, lipids, adiponectin, and C-reactive protein, was performed in 817 pregnant women. The OGTT identified 198 women with GDM, 142 with gestational impaired glucose tolerance, and 477 with normal glucose tolerance. Results: Median leptin (ng/ml) did not differ between the normal glucose tolerance (33.7), gestational impaired glucose tolerance (36.3), and GDM (36.4) groups (P= 0.085). On univariate correlation analysis, leptin was most strongly associated with prepregnancy body mass index (BMI) (r = 0.54, P < 0.0001), fasting insulin (r = 0.60, P < 0.0001), and C-reactive protein (r = 0.38, P < 0.0001) but only weakly associated with area under the glucose curve (AUCglucose) on the OGTT (r = 0.10, P = 0.0066). On multiple linear regression analysis, the strongest independent determinant of leptin was prepregnancy BMI (t = 11.55, P < 0.0001), whereas AUCglucose was not a significant predictor (t = −0.95, P = 0.34). Furthermore, although its respective associations with fasting insulin, triglycerides, and adiponectin varied across tertiles of prepregnancy BMI, leptin was not significantly associated with AUCglucose in any BMI tertile. Conclusions: Pregravid BMI, rather than gestational glucose tolerance, is the primary determinant of serum leptin concentration in pregnancy.

KW - adiponectin

KW - C reactive protein

KW - cholesterol

KW - high density lipoprotein cholesterol

KW - insulin

KW - leptin

KW - triacylglycerol

KW - very low density lipoprotein cholesterol

KW - adult

KW - area under the curve

KW - article

KW - body mass

KW - body weight

KW - disease association

KW - female

KW - glucose intolerance

KW - human

KW - insulin blood level

KW - lipid blood level

KW - multiple linear regression analysis

KW - oral glucose tolerance test

KW - outcome assessment

KW - pregnancy

KW - pregnancy diabetes mellitus

KW - priority journal

KW - protein blood level

KW - univariate analysis

KW - Adiponectin

KW - Adult

KW - Blood Glucose

KW - Body Weight

KW - C-Reactive Protein

KW - Diabetes, Gestational

KW - Female

KW - Glucose Intolerance

KW - Glucose Tolerance Test

KW - Humans

KW - Insulin

KW - Insulin Resistance

KW - Leptin

KW - Lipids

KW - Pregnancy

U2 - 10.1210/jc.2012-2290

DO - 10.1210/jc.2012-2290

M3 - Article

VL - 97

SP - 4148

EP - 4155

JO - Journal of Clinical Endocrinology and Metabolism

JF - Journal of Clinical Endocrinology and Metabolism

SN - 0021-972X

IS - 11

ER -