Abnormal glucose tolerance is associated with diminished postload change in leptin levels in women.
BACKGROUND
It is generally accepted that the metabolic effects of leptin are diminished in the obese due to leptin resistance. Hormone resistance may develop if diurnal (including meal-related) changes in hormone levels are disrupted. We sought to describe leptin changes after a 75 g oral glucose tolerance test (OGTT) in women with a prior diagnosis of gestational diabetes mellitus (a high risk group for the metabolic syndrome) compared to that in healthy controls.


METHODS
In 2000 a retrospective cohort study was performed on women who had been diagnosed with gestational diabetes mellitus (WHO criteria 1985, n = 57) between 1996 and 1998 and on a healthy control female group (n = 36) all of whom had had a prior pregnancy without any diagnosis of diabetes. All the women underwent a standard 75 g OGTT. Serum leptin was measured by radioimmunoassay before and 90 min after the OGTT.


RESULTS
Using multilevel models of change, fasting leptin levels were shown to be associated with body mass index; 10.1% (95% CI 8.1-12.1%) increase per 1 kg/m(2) increase in body mass index), homeostasis model assessment insulin sensitivity; 0.4% (95% CI 0.2-0.7%) decrease per 1% increase in insulin sensitivity); abnormal glucose tolerance (24% decrease, 95% CI 8-37%); and smoking (31% decrease, 95% CI 16-44%). Postload (90 min) leptin levels decreased significantly in women with normal glucose tolerance by 13% (95% CI 8-18%), while no significant change in postload leptin level was apparent in women with abnormal glucose tolerance (3% increase, 95% CI -4% to 29%).


CONCLUSIONS
Disturbed leptin changes were found following an OGTT in women with abnormal glucose tolerance that might be either a cause or a consequence of leptin resistance.
Madarász
Eszter
E
Semmelweis University School of PhD Studies, Department of Medicine, Budapest, Hungary. madeszt@yahoo.com
Tabák
Adám Gy
AG
Speer
Gábor
G
Lakatos
Péter
P
Kerényi
Zsuzsa
Z
Tamás
Gyula
G
D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D018149:Glucose Intolerance / Q000097:blood / Q000503:physiopathology*; D005951:Glucose Tolerance Test; D006801:Humans; D007333:Insulin Resistance; D020738:Leptin / Q000097:blood*; D015233:Models, Statistical; D011247:Pregnancy; D012189:Retrospective Studies; D012907:Smoking; D013997:Time Factors
D020738:Leptin