Comparison of both insulin resistance and insulin sensitivity and their relations with serum leptin concentrations and body fat percentage in a pregnant women with and without gestational diabetes
Öz
Aim: Gestational diabetes and obesity are the common metabolic disorders during pregnancy. Leptin primarily produced by fat cells, has been shown to regulate energy metabolism. There is limited data regarding to this subject in gestational diabetes. In this study it was aimed that the comparison of body fat percentage and leptin levels in pregnant women with or without gestational diabetes. Method: 49 pregnant women with gestational diabetes and 37 healty pregnant women between 26.–36. gestational weeks have been evaluated. Body mass index and skinfold thickness have been calculated antropometrically. Body fat percantage has been calculated from skinfold thickness according to Siri formula. Serum insulin and leptin levels have been mesaured. For evalution of insulin sensitivity, QUICKI-IS; for evalution of insulin resistance, HOMA-IR indexes have been used. Results: Both groups were similar according to gestational weeks and BMI (p>0.05). Body fat percantage (p=0.007), insulin (p=0.004) and HOMA–IR (p<0.001) have found higher; while QUICKI-IS (p<0.001) lower in pregnant women with Gestational diabetes than control group. Significantly positive correlation has been found between body fat percantage and leptin(p< 0.001) insulin (p=0.04) and HOMA-IR (p=0.04), but negative correlated with QUICKI-IS (p<0.001). Conclusion: Consequently, increased body fat percantage in gestational diabetes, increases serum leptin levels and insulin resistance, but decreases the insulin sensitivity. Calculate of body fat percantage by measurement of skinfold thickness has been seen as suitable, inexpensive and save method in pregnant women.
Anahtar Kelimeler
Gestational diabetes mellitus leptin insulin resistance insulin sensistivity
Kaynakça
- 1. American Diabetes Association. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes. Diabetes Care. 2019 ;42(Suppl 1):S13-S282-Johns EC, Denison FC, Norman JE, Reynolds RM.Gestational Diabetes Mellitus: Mechanisms, Treatment, and Complications. Trends Endocrinol Metab. 2018 Nov;29(11):743-7543-Nielsen KK, O'Reilly S, Wu N, Dasgupta K, Maindal HT.Development of a core outcome set for diabetes after pregnancy prevention interventions (COS-DAP): a study protocol. Trials. 2018 ;29:708. 4- Shen Y, Li W, Leng J, Zhang S, Liu H, Li W, Wang L, Tian H, Chen J, Qi L, Yang X, Yu Z, Tuomilehto J, Hu G.High risk of metabolic syndrome after delivery in pregnancies complicated by gestational diabetes.Diabetes Res Clin Pract. 2019;150:219-226.5- Ryan AS. Improvements in insulin sensitivity after aerobic exercise and weight loss in older women with a history of gestational diabetes and type 2 diabetes mellitus. Endocr Res. 2016;41:132-1416- Beneventi F, Locatelli E, De Amici M, Cavagnoli C, Bellingeri C, De Maggio I, Ruspini B, Spinillo A.Maternal and fetal Leptin and interleukin 33 concentrations in pregnancy complicated by obesity and preeclampsia.J Matern Fetal Neonatal Med. 2019 Mar 27:1-7.7- Matafome P, Seiça R.Function and Dysfunction of Adipose Tissue.Adv Neurobiol. 2017;19:3-318-Zhang S, Wang L, Zan L. Investigation into the underlying molecular mechanisms of white adipose tissue through comparative transcriptome analysis of multiple tissues.Mol Med Rep. 2019 ;19:959-966.9-Xu J, Zhao YH, Chen YP, Yuan XL, Wang J, Zhu H, Lu CM.Maternal circulating concentrations of tumor necrosis factor-alpha, leptin, and adiponectin in gestational diabetes mellitus:a systematic review and meta-analysis. Scientific World Journal. 2014;2014:926932. 10- Zhang Y, Zhang HH, Lu JH, Zheng SY, Long T, Li YT, Wu WZ, Wang F.Changes in serum adipocyte fatty acid-binding protein in women with gestational diabetes mellitus and normal pregnant women during mid- and late pregnancy.J Diabetes Investig. 2016 ;7:797-80411- Yang M, Peng S, Li W, Wan Z, Fan L, Du Y.Relationships between plasma leptin levels, leptin G2548A, leptin receptor Gln223Arg polymorphisms and gestational diabetes mellitus in Chinese population.Sci Rep. 2016 Apr 1;6:23948. doi: 10.1038/srep23948.12-Šimják P, Cinkajzlová A, Anderlová K, Pařízek A, Mráz M, Kršek M, Haluzík M.The role of obesity and adipose tissue dysfunction in gestational diabetes mellitus.J Endocrinol. 2018 ;238:R63-R77.13- Gualdi-Russo E, Toselli S, Squintani L. Remarks on methods for estimating body composition parameters: reliability of skinfold and multiple frequency bioelectric impedance methods. Z Morphol Anthropol. 1997;81:321–3114- Wang J, Thornton JC, Kolesnik S, Pierson RN, Jr. Anthropometry in body composition: an overview. Ann N Y Acad.Sci. 2000;904:317–2615- Lohman TG, Roche, AF, Martorell R, eds. Anthropometric Standardization Reference Manual. Champaign, IL: Human Kinetics; 1988 pp. 8–80.16- American Diabet Association Position Statement. Gestational diabetes mellitus. Diabetes Care. 2004;27:S88–S90.17- Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RCHomeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985 Jul;28(7):412-918- Katz A, Nambi SS, Mather K, Baron AD, Follmann DA, Sullivan G, Quon MJ.Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab. 2000 Jul;85(7):2402-1019 - Retnakaran R, Ye C, Kramer CK, Connelly PW, Hanley AJ, Sermer M, Zinman B.Evaluation of Circulating Determinants of Beta-Cell Function in Women With and Without Gestational Diabetes.J Clin Endocrinol Metab. 2016 Jul;101(7):2683-91. 20- da Silva AA, Hall JE, do Carmo JM.Leptin reverses hyperglycemia and hyperphagia in insulin deficient diabetic rats by pituitary-independent central nervous system actions.PLoS One. 2017 Nov 30;12(11):e0184805. 21- Echwald SM, Clausen JO, Hansen T, Urhammer SA, Hansen L, Dinesen B, Borch-Johnsen K. Analysis of the relationship between fasting serum leptin levels and estimates of beta-cell function and insulin sensitivity in a population sample of 380 healthy young Caucasians. Eur J Endocrinol; 1999: 140:180-522- Zheng X, Niu S.Leptin-induced basal Akt phosphorylation and its implication in exercise-mediated improvement of insulin sensitivity. Biochem Biophys Res Commun. 2018;496:37-4323-Ye Z, Liu G, Guo J, Su Z.Hypothalamic endoplasmic reticulum stress as a key mediator of obesity-induced leptinresistance.Obes Rev. 2018;19:770-785. 24- Zhu D, Yan Q, Li Y, Liu J, Liu H, Jiang Z.Effect of Konjac Mannan Oligosaccharides on Glucose Homeostasis via the Improvement of Insulinand Leptin Resistance In Vitro and In Vivo. Nutrients. 2019 Jul 24;11(8). pii: E1705. doi: 10.3390/nu11081705.25- Nemeth A, Segrestin B, Leporq B, Seyssel K, Faraz K, Sauvinet V, Disse E, Valette PJ, Laville M, Ratiney H, Beuf O.3D Chemical Shift-Encoded MRI for Volume and Composition Quantification of Abdominal AdiposeTissue During an Overfeeding Protocol in Healthy Volunteers. J Magn Reson Imaging. 2019 Jun;49(6):1587-1599.26- Tang Y, Qiao P, Qu X, Bao Y, Li Y, Liao Y, Ying H.Comparison of serum vaspin levels and vaspin expression in adipose tissue and smooth muscle tissue in pregnant women with and without gestational diabetes.Clin Endocrinol (Oxf). 2017 Oct;87:344-34927- Forsum E, Sadurskis A, and Wagner J. Resting metabolic rate and body composition in healthy Swedish women during pregnancy. Am J Clin Nutr 1988;.47: 942–947,28- Lawrence M, Lawrence F, Coward WA, Cole TJ, and Whitehead RG. Energy requirements of pregnancy in the Gambia. Lancet 1987;ii: 1072–1076,29- Okereke NC, Huston-Presley L, Amini SB, Kalhan S, Catalano PM. Longitudinal changes in energy expenditure and body composition in obese women with normal and impaired glucose tolerance. Am J Physiol Endocrinol Metab. 2004 ;287(3):E472-9.30- Sommer C, Mørkrid K, Jenum AK, Sletner L, Mosdøl A, Birkeland KI. Weight gain, total fat gain and regional fat gain during pregnancy and the association with gestational diabetes: a population-based cohort study.Int J Obes (Lond). 2014 ;38:76-81.
Gestasyonel diabeti olan ve olmayan gebe kadınlarda serum leptin konsantrasyonlarıyla vücut yağ oranı değerlerinin kıyaslanması ve insülin direnci ile insülin duyarlılığı ile ilişkisi
Öz
Amaç: Gestasyonel diabet ile obesite gebelikte sık görülen metabolik bozukluklar arasında yer almaktadır. Leptin başlıca yağ dokusu hücreleri tarafından üretilerek dolaşıma salınan bir peptiddir. Leptin’in karbonhidrat metabolizması ve insülin direnci üzerine tanımlanmiş birçok etkileri bildirilmiştir; ancak gestasyonel diabet ile arasındaki ilişkiye ait veriler kısıtlıdır. Bundan ötürü bu çalışmada sağlıklı ve gestasyonel diabetli gebelerdeki vücut yağ yüzdesi, serum insülin ve leptin düzeylerinin kıyaslanarak gestasyonel diabet üzerine olası etkilerinin değerlendirilmesi amaçlanmıştır. Yöntem: Bu çalışmada 26 ile 36. gebelik haftaları arasındaki 49 gestasyonel diabetli ve 37 sağlıklı gebe incelendi. Vücut kitle indeksi ve cilt kıvrım kalınlıkları ölçüldü. Vücut yağ yüzdesi Siri formülüyle hesaplandı. Serum açlık glukoz, insülin ve leptin seviyeleri ölçüldü. İnsülin duyarlılığının değerlendirilmesinde QUICKI-IS, insülin direncinin değerlendirilmesinde ise HOMA-IR indeksleri kullanıldı. Bulgular: Gebelik haftası, yaş ve vücut kitle indeksi bakımından her iki grup arasında anlamlı fark bulunmadı (p>0.05). Gestasyonel diabetli gebelerde Vücut yağ yüzdesi (p=0.007), serum insülin (p=0.004) , leptin düzeyleri (p=0.044) ve HOMA–IR (p<0.001) sağlıklı gebelere kıyasla daha yüksek saptanırken; QUICKI-IS ise anlamlı derecede düşük bulundu (p<0.001). Korelasyon analizinde vücut yağ oranı ile serum leptin (p<0.001), insülin (p=0.04) ve HOMA-IR arasında (p=0.04) anlamlı pozitif korelasyon; QUICKI-IS ile ise (p<0.001) anlamlı ters korelasyon bulundu. Sonuç: Gestasyonel diabetli gebelerde sağlıklı gebelere kıyasla artmış olan vücut yağ oranı; leptin düzeylerinin ve insülin direncinin artmasına, insülin duyarlılığının ise azalmasına yol açabileceği düşünülmüştür. Cilt kıvrım kalınlığı ölçülerek vücut yağ yüzdesinin hesaplanması, günlük klinik uygulamalarda gebeler için güvenilir, ucuz ve uygun bir yöntem gibi görünmektedir.
Anahtar Kelimeler
Gestasyonel Diabetes Mellitus Leptin İnsülin Direnci insülin duyarlılığı vücut yağ yüzdesi
Kaynakça
- 1. American Diabetes Association. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes. Diabetes Care. 2019 ;42(Suppl 1):S13-S282-Johns EC, Denison FC, Norman JE, Reynolds RM.Gestational Diabetes Mellitus: Mechanisms, Treatment, and Complications. Trends Endocrinol Metab. 2018 Nov;29(11):743-7543-Nielsen KK, O'Reilly S, Wu N, Dasgupta K, Maindal HT.Development of a core outcome set for diabetes after pregnancy prevention interventions (COS-DAP): a study protocol. Trials. 2018 ;29:708. 4- Shen Y, Li W, Leng J, Zhang S, Liu H, Li W, Wang L, Tian H, Chen J, Qi L, Yang X, Yu Z, Tuomilehto J, Hu G.High risk of metabolic syndrome after delivery in pregnancies complicated by gestational diabetes.Diabetes Res Clin Pract. 2019;150:219-226.5- Ryan AS. Improvements in insulin sensitivity after aerobic exercise and weight loss in older women with a history of gestational diabetes and type 2 diabetes mellitus. Endocr Res. 2016;41:132-1416- Beneventi F, Locatelli E, De Amici M, Cavagnoli C, Bellingeri C, De Maggio I, Ruspini B, Spinillo A.Maternal and fetal Leptin and interleukin 33 concentrations in pregnancy complicated by obesity and preeclampsia.J Matern Fetal Neonatal Med. 2019 Mar 27:1-7.7- Matafome P, Seiça R.Function and Dysfunction of Adipose Tissue.Adv Neurobiol. 2017;19:3-318-Zhang S, Wang L, Zan L. Investigation into the underlying molecular mechanisms of white adipose tissue through comparative transcriptome analysis of multiple tissues.Mol Med Rep. 2019 ;19:959-966.9-Xu J, Zhao YH, Chen YP, Yuan XL, Wang J, Zhu H, Lu CM.Maternal circulating concentrations of tumor necrosis factor-alpha, leptin, and adiponectin in gestational diabetes mellitus:a systematic review and meta-analysis. Scientific World Journal. 2014;2014:926932. 10- Zhang Y, Zhang HH, Lu JH, Zheng SY, Long T, Li YT, Wu WZ, Wang F.Changes in serum adipocyte fatty acid-binding protein in women with gestational diabetes mellitus and normal pregnant women during mid- and late pregnancy.J Diabetes Investig. 2016 ;7:797-80411- Yang M, Peng S, Li W, Wan Z, Fan L, Du Y.Relationships between plasma leptin levels, leptin G2548A, leptin receptor Gln223Arg polymorphisms and gestational diabetes mellitus in Chinese population.Sci Rep. 2016 Apr 1;6:23948. doi: 10.1038/srep23948.12-Šimják P, Cinkajzlová A, Anderlová K, Pařízek A, Mráz M, Kršek M, Haluzík M.The role of obesity and adipose tissue dysfunction in gestational diabetes mellitus.J Endocrinol. 2018 ;238:R63-R77.13- Gualdi-Russo E, Toselli S, Squintani L. Remarks on methods for estimating body composition parameters: reliability of skinfold and multiple frequency bioelectric impedance methods. Z Morphol Anthropol. 1997;81:321–3114- Wang J, Thornton JC, Kolesnik S, Pierson RN, Jr. Anthropometry in body composition: an overview. Ann N Y Acad.Sci. 2000;904:317–2615- Lohman TG, Roche, AF, Martorell R, eds. Anthropometric Standardization Reference Manual. Champaign, IL: Human Kinetics; 1988 pp. 8–80.16- American Diabet Association Position Statement. Gestational diabetes mellitus. Diabetes Care. 2004;27:S88–S90.17- Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RCHomeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985 Jul;28(7):412-918- Katz A, Nambi SS, Mather K, Baron AD, Follmann DA, Sullivan G, Quon MJ.Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab. 2000 Jul;85(7):2402-1019 - Retnakaran R, Ye C, Kramer CK, Connelly PW, Hanley AJ, Sermer M, Zinman B.Evaluation of Circulating Determinants of Beta-Cell Function in Women With and Without Gestational Diabetes.J Clin Endocrinol Metab. 2016 Jul;101(7):2683-91. 20- da Silva AA, Hall JE, do Carmo JM.Leptin reverses hyperglycemia and hyperphagia in insulin deficient diabetic rats by pituitary-independent central nervous system actions.PLoS One. 2017 Nov 30;12(11):e0184805. 21- Echwald SM, Clausen JO, Hansen T, Urhammer SA, Hansen L, Dinesen B, Borch-Johnsen K. Analysis of the relationship between fasting serum leptin levels and estimates of beta-cell function and insulin sensitivity in a population sample of 380 healthy young Caucasians. Eur J Endocrinol; 1999: 140:180-522- Zheng X, Niu S.Leptin-induced basal Akt phosphorylation and its implication in exercise-mediated improvement of insulin sensitivity. Biochem Biophys Res Commun. 2018;496:37-4323-Ye Z, Liu G, Guo J, Su Z.Hypothalamic endoplasmic reticulum stress as a key mediator of obesity-induced leptinresistance.Obes Rev. 2018;19:770-785. 24- Zhu D, Yan Q, Li Y, Liu J, Liu H, Jiang Z.Effect of Konjac Mannan Oligosaccharides on Glucose Homeostasis via the Improvement of Insulinand Leptin Resistance In Vitro and In Vivo. Nutrients. 2019 Jul 24;11(8). pii: E1705. doi: 10.3390/nu11081705.25- Nemeth A, Segrestin B, Leporq B, Seyssel K, Faraz K, Sauvinet V, Disse E, Valette PJ, Laville M, Ratiney H, Beuf O.3D Chemical Shift-Encoded MRI for Volume and Composition Quantification of Abdominal AdiposeTissue During an Overfeeding Protocol in Healthy Volunteers. J Magn Reson Imaging. 2019 Jun;49(6):1587-1599.26- Tang Y, Qiao P, Qu X, Bao Y, Li Y, Liao Y, Ying H.Comparison of serum vaspin levels and vaspin expression in adipose tissue and smooth muscle tissue in pregnant women with and without gestational diabetes.Clin Endocrinol (Oxf). 2017 Oct;87:344-34927- Forsum E, Sadurskis A, and Wagner J. Resting metabolic rate and body composition in healthy Swedish women during pregnancy. Am J Clin Nutr 1988;.47: 942–947,28- Lawrence M, Lawrence F, Coward WA, Cole TJ, and Whitehead RG. Energy requirements of pregnancy in the Gambia. Lancet 1987;ii: 1072–1076,29- Okereke NC, Huston-Presley L, Amini SB, Kalhan S, Catalano PM. Longitudinal changes in energy expenditure and body composition in obese women with normal and impaired glucose tolerance. Am J Physiol Endocrinol Metab. 2004 ;287(3):E472-9.30- Sommer C, Mørkrid K, Jenum AK, Sletner L, Mosdøl A, Birkeland KI. Weight gain, total fat gain and regional fat gain during pregnancy and the association with gestational diabetes: a population-based cohort study.Int J Obes (Lond). 2014 ;38:76-81.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Nisan 2020 |
| Gönderilme Tarihi | 9 Ekim 2019 |
| Kabul Tarihi | 16 Ocak 2020 |
| Yayımlandığı Sayı | Yıl 2020 Cilt: 13 Sayı: 1 |
Kaynak Göster
MEÜ
Sağlık Bilimleri Dergisi Doç.Dr. Gönül Aslan'ın Editörlüğünde Mersin
Üniversitesi Sağlık Bilimleri Enstitüsüne bağlı olarak 2008 yılında
yayımlanmaya başlanmıştır. Prof.Dr. Gönül Aslan Mart 2015 tarihinde Başeditörlük görevine Prof.Dr.
Caferi Tayyar Şaşmaz'a devretmiştir. 01 Ocak 2023 tarihinde Prof.Dr. C. Tayyar Şaşmaz Başeditörlük görevini Prof.Dr. Özlem İzci Ay'a devretmiştir.
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