Leptin during and after preeclamptic or normal pregnancy: Its relation to serum insulin and insulin sensitivity

Hyperleptinemia may be part of the insulin resistance syndrome. We studied serum leptin in preeclampsia, which is an insulin-resistant state, and soug ht associations between leptin and insulin or insulin sensitivity during an d after pregnancy. Twenty-two proteinuric preeclamptic women and 16 normote nsive controls were studied during the third trimester. Leptin was higher i n preeclampsia (mean +/- SE, 34.6 +/- 3.9 v 20.0 +/- 3.3 mu g/L, P = .002) and correlated directly with the level of proteinuria (r = .47, P = .03) an d normal pregnancy (r = .52, P = .04), whereas insulin sensitivity as asses sed by an intravenous glucose tolerance test showed no relationship to lept in. Leptin was 19.0 +/- 3.6 mu g/L in 14 preeclamptic women and 10.1 +/- 2. 0 mu g/L (P = .11) in 11 controls 3 months after delivery. Leptin correlate d directly with insulin both in preeclamptic puerperal women (r = .63, P = .02) and in controls (r = .81, P = .003). Leptin and insulin sensitivity co rrelated only in preeclamptic puerperal women (r = -.59, P = .02). In concl usion, (1) serum leptin is elevated in preeclampsia, (2) insulin is an impo rtant determinant of serum leptin in preeclamptic and normotensive women bo th during pregnancy and in the puerperium, and (3) hyperleptinemia may be p art of the insulin resistance syndrome also in women with prior preeclampsi a, Copyright (C) 2000 by W.B. Saunders Company.