Influence of leptin and the TNF system on insulin resistance in pregnancy and their effect on anthropometric parameters of newborns.
BACKGROUND
We studied the contribution of the tumor necrosis factor system and leptin to insulin resistance during the course of normal pregnancy.


METHODS
Forty-five healthy pregnant women (15 in the 1st, 15 in the 2nd2 and 15 in the 3rd3 trimester) and 25 age-matched healthy nonpregnant women as controls. Twenty-three newborns delivered by women followed in the 2nd and 3rd trimesters were also investigated. Fasting serum immunoreactive tumor necrosis factor-alpha, soluble tumor necrosis factor receptor-1, soluble tumor necrosis factor receptor-2, leptin (by enzyme-linked immunoassay) and C-peptide (by radioimmunoassay) concentrations in the patients and controls were measured. Body weight, length and head circumference of the newborns were analyzed in connection with the measured maternal parameters.


RESULTS
Significantly elevated tumor necrosis factor-alpha, tumor necrosis factor receptor-1 and -2, leptin, and C-peptide levels were found in the 3rd3 trimester as compared with the 1st1 and 2nd2 trimesters and with the nonpregnant controls. Tumor necrosis factor-alpha, tumor necrosis factor receptor-2, C-peptide, leptin concentrations and body mass index were found to be in a significant positive linear correlation with each other. Significant negative linear correlations were calculated among maternal serum C-peptide, tumor necrosis factor-alpha and leptin concentrations and the head circumference of the newborns.


CONCLUSIONS
In conclusion, increased tumor necrosis factor-alpha and leptin levels may contribute to insulin resistance in late pregnancy. Tumor necrosis factor-alpha and leptin may be regulators of intrauterine bone development of newborns.
Melczer
Zsolt
Z
2nd Department of Obstetrics and Gynecology, Faculty of Medicine of Semmelweis University, Budapest, Hungary. melczer@noi2.sote.hu
Bánhidy
Ferenc
F
Csömör
Sándor
S
Tóth
Péter
P
Kovács
Margit
M
Winkler
Gábor
G
Cseh
Károly
K
D000328:Adult; D000886:Anthropometry / Q000379:methods; D015703:Antigens, CD / Q000097:blood; D001724:Birth Weight; D001827:Body Height; D015992:Body Mass Index; D002096:C-Peptide / Q000097:blood*; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007333:Insulin Resistance; D020738:Leptin / Q000097:blood*; D011247:Pregnancy / Q000097:blood*; D011264:Pregnancy Trimesters; D011863:Radioimmunoassay; D054411:Receptors, Leptin; D018124:Receptors, Tumor Necrosis Factor / Q000097:blood*; D047889:Receptors, Tumor Necrosis Factor, Type II; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
D015703:Antigens, CD; D002096:C-Peptide; C515448:LEPR protein, human; D020738:Leptin; D054411:Receptors, Leptin; D018124:Receptors, Tumor Necrosis Factor; D047889:Receptors, Tumor Necrosis Factor, Type II; D014409:Tumor Necrosis Factor-alpha