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

    Fingerprint

    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

    Cite this

    @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",
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    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 journalArticle

    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

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    SP - 4148

    EP - 4155

    JO - Journal of Clinical Endocrinology and Metabolism

    JF - Journal of Clinical Endocrinology and Metabolism

    SN - 0021-972X

    IS - 11

    ER -