Study On The Relationship Between Leptin And Insulin Resistance In Patients With Pregnancy Induced Hypertension

Objective:Pregnancy-induced hypertension syndrome(Pih),is a common and severe obstetric syndrome,and is a major cause of maternal and fetal morbility and mortality , whose etiology and pathophysiology are still not understood. Recent data suggest that pathophsiology of Pih is relation to leptin or hyperinsulinemia or insulin resistance . Evaluating the insulin resistance and B-cell fuction, specificly measured the concentration of insulin is the sticking point.We investigated the levels of leptin(Pi) and insulin(I) and proinsulin(Pi) and true insulin(Ti) and glucose(Glu) from the periheral blood, and knew the difference from the Pih and the normal pregnancy, in order to illuminate the significance of leptin and insulin resistance in the development of hypertensive disorder complicating pregnancy and the relationship of the two, so we could get the evidence to studying the mechanisms of Pih and the new approach of therapy. Methods: The study group consisted of 50 women with pih, the control group consisted of 30 women with normal pregnancy. The serum levels of leptin and proinsulin and true insulin were measured by ELISA(Enzyme-linked immunosorbent assay), the serum levels of insulin was measured by RIA (Radioimmunoassay), the serum level of gluose was measured by glucose-card. The ratial of Pi/Ti(proinsuli/true insulin) expressed B-cell secreting fuction and insulin sensitivity index expressed the insulin sensitivity. The data was showed by ±S or G±s , Pi/Ti was analysed after changed to the normal distribution. All data were analyzed with the SPSS10.0 software, including t-test,Q-test, ANOVA and linear correlation. Results: 1.The comparisons of leptin and insulin and proinsulin and true insulin and glucose in two groups: the median leptin concentration was significantly higher in Pih than in normal pregnancy: compared with control group , the concentration of leptin was obviously higher in mild Pih or middle Pih or severe Pih. Among Pih groups, it had significant statistical difference. The median insulin concentration was significantly higher in Pih than in normal pregnancy: compared with control group , the concentration of insulin was obviously higher in mild Pih or middle Pih or severe Pih. Among Pih groups, it had significant statistical difference. The median proinsulin concentration was significantly higher in Pih than in normal pregnancy: compared with control group, the concentration of proinsulin was obviously higher in mild Pih or middle Pih or severe Pih. Among Pih groups, it had significant statistical difference. But there was no significantly different concentration of true insulin between Pih group and control group, and there was no significantly different concentration of true insulin among Pih groups. Also there was no statistical between Pih group and control group or among groups. 2. Comparisons of Pi/Ti and insulin sensitivity index in two groups: the ratial of Pi/Ti was significantly higher in Pih than in normal pregnancy: compared with control group, the ratial of Pi/Ti was obviously higher in mild Pih or middle Pih or severe Pih. Among Pih groups, it had no significant statistical difference between severe Pih and middle Pih or between middle Pih and mild Pih, but it was obviously higher in severe Pih than mild Pih. The median insulin sensitivity index was significantly lower in Pih than in normal pregnancy: compared with control group , the concentration of leptin was obviously lower in mild Pih or middle Pih or severe Pih. Among Pih groups, it also had significant statistical difference. 3. The correlation of lptin showed significant correlation with proinsulin and negativity correlation with insulin sensitivity index. Conclusions:1. There was hyperinsulinmia in Pih. With the development of Pih, proinsulin was increasing, but true insulin was not changed. It showed that hyperinsulinmia was actually hyperproinsulin, not hypertrueinsulinmia. 2. There was hyperleptinmia in Pih also, so leptin and proinsulin were close to Pih. From the study,we could conclude leptin and proinsulin may be involed in the development of Pih. 3.There was B -cell dysfuction in Pih. It was signed by Pi or Pi/Ti. From the study, we could know Pi increasing was ealier than Pi/Ti increasing. 4.Through...