Maternal serum levels of adiponectin and leptin in non-pregnant, normal pregnant and preeclamptic women
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Date
2015-11-18
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Abstract
Adiponectin and leptin, bioactive substances produced and secreted by the adipose tissue
and the placenta, are involved in the regulation of a variety of endocrine processes in the body. Limited and contradictory data exist, regarding the roles of adiponectin and leptin in
normal pregnancy and preeclampsia. This study, therefore, sought to investigate the
maternal serum levels of adiponectin and leptin during normal pregnancy and
preeclampsia. A non-randomized case-control study was conducted among pregnant
women who sought antenatal care at the Manhyia Government Hospital between January
2014 and March 2014. Forty non-pregnant women, sixty normal first trimester pregnant
women, sixty normal second trimester pregnant women, sixty normal third trimester
pregnant women and sixty preeclamptic third trimester women were enrolled in the study.
The medical history, Body Mass Index and Blood Pressure of each participant were
measured; and their blood and urine samples were collected for biochemical analysis.
Among the non-pregnant women, adiponectin correlated significantly but inversely with
leptin (r=-0.402, p<0.05) and BMI (r=-0.684, p<0.05), and leptin correlated significantly
and directly with BMI (r=0.571, p<0.05). Among the pregnant women, adiponectin
correlated significantly and inversely with leptin (r=-0.669, p<0.05), BMI (r=-0.620,
p<0.05), and leptin correlated significantly and directly with BMI (r=0.710, p<0.05).
Among the preeclamptic women, adiponectin correlated insignificantly with leptin (r=-
0.290, p>0.05) but significantly and inversely with BMI (r=-0.521, p<0.05), and leptin
correlated significantly and directly with BMI (r=0.700, p<0.05). While adiponectin levels
(p<0.05) and the adiponectin-leptin ratio (p<0.05) were higher in the normal-weight
women than in their overweight counterparts, the exact opposite held true for leptin levels
(p<0.05). With regards to the levels of the adipokines in the participants, adiponectin
levels were highest in the first trimester pregnant women, higher in the non-pregnant
women, high in the second trimester pregnant women and low in the third trimester
pregnant women (p<0.05).Leptin levels, on the other hand, remained comparable between
the non-pregnant and the first trimester pregnant women (p>0.05), high in the second
trimester pregnant women and highest in the third trimester pregnant women (p<0.05).The
adiponectin-leptin ratio was comparable between the non-pregnant women and the first
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trimester pregnant women (p>0.05), low in the second trimester pregnant women and
lowest in the third trimester pregnant women (p<0.05). The levels of adiponectin (p<0.05),
leptin (p<0.05) and the adiponectin-leptin ratio (p<0.05) were higher in the preeclamptic
women than in the normal pregnant women. In assessing overweight, gravidity and parity
as possible determinants of preeclampsia, it was observed that overweight women are at a
higher risk to developing preeclampsia than their normal-weight counterparts [OR=2.14
(0.93 – 9.84), p<0.05)], primigravida pregnant women are at a higher risk of developing
preeclampsia than multigravida pregnant women [OR =3.57(1.524-8.37), p<0.05]. It was
also observed that nulliparous pregnant women are at a higher risk of developing
preeclampsia than multiparous pregnant women [OR =3.88 (1.30-11.62), p<0.05], but at
comparable risk with primiparous pregnant women at developing preeclampsia
[OR=1.9(0.87-4.18), p>0.05]. However, primigravidity and nulliparity, as risk factors to
developing preeclampsia, were observed to be independent on the pre-pregnancy levels of
adiponectin and leptin, due to the comparable levels of each adipokine among the
pregnant women on the bases of gravidity and parity (p>0.05). Among non-pregnant and
normal pregnant women, adiponectin and leptin exhibit an inverse relationship, and while
adiponectin varies inversely with BMI and gestational age, leptin varies directly with BMI
and gestational age. However, on the emergence of preeclampsia, a condition whose
occurrence is possibly dependent on the gravidity and parity status of a woman, and
alterations in the adiponectin-leptin ratio which is partly influenced by body weight, some
of these relationships become blunted, as the levels of adiponectin and leptin rise
significantly. The fluctuations in the levels of adiponectin and leptin during normal
pregnancy indicate that adiponectin and leptin may play vital roles during pregnancy; and
the observed elevated levels of adiponectin, leptin and the adiponectin-leptin ratio during
preeclampsia, indicates that knowledge of the levels and ratio of the two adipokines during
pregnancy, could assist in the diagnosis and treatment of preeclampsia.
Description
A thesis submitted to the School of Graduate Studies, Kwame Nkrumah University of Science and Technology in partial fulfillment of the requirements for the award of the Degree of Master of Philosophy in Chemical Pathology.