Serum leptin levels during pregnancy in multiple sclerosis.
BACKGROUND
Disease activity in patients with multiple sclerosis (MS) is suppressed during pregnancy, whereas attack frequency increases after delivery. It is yet unclear, which immuno - endocrinological processes mediate these disease fluctuations. Leptin has been identified as a hormone that can influence inflammatory activity.


OBJECTIVE
The aim of this study was to investigate whether pregnancy-induced fluctuations of serum leptin levels differed between patients with MS and controls and whether serum leptin levels correlate with periods of enhanced and diminished disease activity.


METHODS
Women with MS and healthy women were prospectively followed during and after pregnancy. The MS group could be studied already at a timepoint before pregnancy. Serum leptin and soluble leptin receptor (SLR) levels were measured using enzyme-linked immunosorbent assay.


RESULTS
Pre-pregnancy serum leptin levels were (mean +/- SD) 22.9 +/- 12.8 ng/ml in the MS group. These levels increased in the third trimester to 28.5 +/- 15.0 ng/ml (P = 0.007). The third trimester serum leptin levels in healthy women were comparable, 29.4 +/- 19.0 ng/ml. Serum leptin levels after delivery dropped to 18.5 +/- 12.8 ng/ml in women with MS (P < 0.001) and to a lesser extend (22.0 +/- 17.5 ng/ml) in healthy women (P = 0.04). SLR levels showed the same pattern. Remarkably, women with the highest relative decrease in serum leptin levels after delivery had more often a postpartum relapse (P = 0.008).


CONCLUSIONS
In women with MS, leptin increased during late pregnancy. A postdelivery drop in leptin levels was observed in both the MS and control group. The postdelivery drop was associated with the occurrence of postpartum relapse.
Neuteboom
R F
RF
Department of Neurology, Erasmus MC, Rotterdam, The Netherlands.
Verbraak
E
E
Voerman
J S A
JS
van Meurs
M
M
Steegers
E A P
EA
de Groot
C J M
CJ
Laman
J D
JD
Hintzen
R Q
RQ
D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D020738:Leptin / Q000097:blood*; D009103:Multiple Sclerosis / Q000097:blood*; D049590:Postpartum Period / Q000097:blood; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood*; D011264:Pregnancy Trimesters / Q000097:blood; D011446:Prospective Studies; D054411:Receptors, Leptin / Q000097:blood; D012008:Recurrence; D055815:Young Adult
D015415:Biomarkers; C515448:LEPR protein, human; D020738:Leptin; D054411:Receptors, Leptin