Comparison of maternal ghrelin and leptin in healthy mothers and mothers with Type 1 diabetes.
OBJECTIVE
Maternal leptin affects placental growth hormone (GH), whereas ghrelin, a natural ligand of the growth-hormone-secretagogue receptor, modulates GH action. Both hormones may affect fetal growth, and dysregulation in diabetes may lead to fetal growth disturbances. The aim was to investigate changes in maternal ghrelin during pregnancy with diabetes and to establish reference leptin levels.


METHODS
Twelve healthy non-diabetic (ND) and 12 pregnant women with Type 1 diabetes (T1DM) were recruited. Age and body mass index (BMI) [ND: age 29.9 +/- 4.7 years (mean +/- sd), BMI 25.2 +/- 3.7 kg/m2; T1DM: age 31 +/- 5.5 years, BMI 27 +/- 3.1 kg/m2] were similar in the groups. HbA1c in T1DM was 6.2 +/- 1.1% at 20 weeks, 6.3 +/- 1.1% at 30 weeks' gestation and 7.8 +/- 2.1% postpartum. Fasting plasma ghrelin, total leptin, free leptin (FL) and soluble leptin receptor (sOB-R) levels were measured at 20 and 30 weeks' gestation and postpartum and determined by radioimmunoassay.


RESULTS
All pregnancies resulted in full-term singleton births with no differences in birth weight between groups [T1DM: 3.4 +/- 0.56 kg (mean +/- SE); ND: 3.6 +/- 0.3 kg, P = NS]. Ghrelin levels were lower in T1DM when corrected for age and mothers' weight (T1DM: 458 +/- 36 pg/ml and 432.9 +/- 26.6 pg/ml; ND: 562 +/- 52 pg/ml and 515.8 +/- 63 pg/ml at 20 and 30 weeks, respectively, P < 0.05). T1DM mothers had higher levels of sOB-R and FL levels declined at 30 weeks' gestation in T1DM (P = 0.04) but not in ND.


CONCLUSIONS
In a population of pregnant women with expected changes in leptin levels as previously reported, ghrelin levels were lower in T1DM pregnancies at 20 and 30 weeks. This may have implications for fetal development and requires further study in diabetes, particularly in pregnancies that result in macrosomia.
Kos
K
K
The Warwickshire Institute for the Study of Diabetes, Endocrinology & Metabolism (WISDEM), Coventry, UK.
Syn
W-K
WK
Lewandowski
K C
KC
Bennett
J
J
Nwokolo
C U
CU
O'Hare
J P
JP
Randeva
H
H
D000328:Adult; D001724:Birth Weight / Q000502:physiology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D005260:Female; D047109:Fetal Development / Q000502:physiology; D054439:Ghrelin / Q000378:metabolism*; D013006:Growth Hormone / Q000378:metabolism; D006801:Humans; D020738:Leptin / Q000378:metabolism*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics / Q000097:blood*; D012016:Reference Values; D055815:Young Adult
D054439:Ghrelin; D020738:Leptin; D013006:Growth Hormone