The Relationship Of Insulin Resistance With Leptin In Preeclampsia-Eclampsia

Objective: To detect the expression of fasting blood glucose,insulin and leptin of the preeclampsia-eclampsia patients in serum and compared with normal pregnant women. To study the relationship between insulin resistance and the level of leptin of patients with preeclampsia-eclampsia. To investigate the causes of the increse of insulin resistance of preeclampsia-eclampsia patients and help to definite the pathogenesis of preeclampsia-eclampsia.Methods: 33 cases were Preeclampsia-eclampsia, 11 of them were of mild Preeclampsia, the other cases of severe Preeclampsia and eclampsia, those patients did not suffer any other pregnancy complications or medical illness;18 cases were healthy pregnancy gravids matched of age, gestational weeks and other confounding factors. Serum Leptin level was detected by enzyme linked immunoabsorbent assay, fast serum insulin level was detected by radioimmunoassay and fast blood glucose concentration was detected by glucose oxidase method. Using insulin sensitive index ( reciprocal of multiplication result of fast insulin level by fast glucose concentration) to show body insulin sensitivity.Results: The Preeclampsia-eclampsia group was higher serum level of Leptin(2.01 ± 0.73pg/ml), even the mild subgroup's level(1.57 ± 0.50pg/ml) was significantly higher than the control group's(0.97 ± 0.79pg/ml)(p<0.05), the tendency were more clear in severe Preeclampsia and eclampsia patients(2.23 ± 0.74pg/ml);Both groups' fast blood glucose were in the normal content, and there was no apparent difference between them, but the Preeclampsia-eclampsia group serum insulin level(5.27 ± 3.89uIU/ml) was higher, and insulin sensitivity index(-2.94 ± 0.69) waslower than the control(2.67±2.08uIU/ml, -2.27 + 0.45,seperately), the difference is significant even in the mild Preeclampsia subgroup(p<0.05);Liner co-relationship assay showed insulin insensitivity index was negative co-relationship with Leptin ( r = —0.476, p<0.05), but did not have significant co-relationship with gravids' age or body mass index( r = -0.051, p>0.05;r —0.133, p>0.05). We also find out that serum level of Leptin was not apparent positive correlationship with Preeclampsia-eclampsia women's body mass index. Conclusion:(1) The Preeclampsia-eclampsia group especially severe patients had higher serum level of Leptin than that of the control, Leptin may contribute to Preeclampsia-eclampsia's pathogenesis and its severity.(2) The Preeclampsia was More serious, the degree of insulin resistance was more increased.(3) Insulin resistance of Preeclampsia-eclampsia patients increased maybe because the increase of serum level of Leptin, had less relationship with gestational age or body mass index.(4) In Preeclampsia-eclampsia patients, fatty tissue might not be the major source of the increased Leptin, and hypoxia placenta was likely to contribute more. We may forcast the occur of Preeclampsia-eclampsia by examine pregnant women's serum level of leptin.