Öz
Özet
Amaç. Bu çalışmanın amacı midtrimester amniyotik sıvıda leptin ve insülin düzeylerini inceleyerek bunların daha sonraki dönemde gestasyonel diabetes mellitus gelişen olguları tahmin etmede faydalı olup olamayacağını araştırmaktır. Yöntem. Genetik amniyosentezle 16-20 haftalık gebelerden alınan amniyotik sıvı örneklerinde leptin ve insülin düzeylerini araştırdık. Prospektif takiplerde gestasyonel diabetes mellitusta gelişen ve sağlıklı gebelik sürdüren hastaları kaydettik. Bulgular. Gestasyonel diabetes mellitus gelişen grupta amniyotik sıvı leptin (17,3 ng/mL) ve insülin (3,4 ng/mL) düzeyleri kontrol grubunun amniyotik sıvı leptin (10,1 ng/mL) ile amniyotik sıvı insülin (1,7 ng/dL) düzeylerine göre istatistiksel olarak yüksek bulunmuştur. Sonuç. Amniyotik sıvı’da henüz gestasyonel diabetes mellitus bulguları ortaya çıkmadan leptin ve insülin düzeylerinin yüksek bulunması bu proteinlerin gestasyonel diabetes mellitusu önceden tahmin etmede kullanılabileceği kanısını vermektedir.
Anahtar sözcükler: Amniyotik sıvı, leptin, insulin
Abstract
Aim. The aim of this study is to investigate whether amniotic fluid leptin and insulin levels can be used for prediction of for prediction of gestational diabetes mellitus or not. Methods. The levels of leptin and insulin were measured in the samples of amniotic fluid which were obtained at 16-20 weeks of pregnancy during genetic amniocentesis. We recorded the patients who developed gestational diabetes mellitus and who had healthy gestation. Results. Amniotic fluid leptin (17.3 ng/mL) and insulin (3.4 ng/mL) levels were significantly increased in gestational diabetes mellitus group as compared to control group’s amniotic fluid leptin (10.1 ng/mL) and amniotic fluid insülin (1.7 mg/mL) levels. Conclusion. Increased levels of amniotic fluid leptin and insulin levels before gestational diabetes mellitus symptoms gives the idea that these proteins can be used as predictors for gestational diabetes mellitus.
Keywords: Amniotic fluid, leptin, insulin
Anahtar Kelimeler
Kaynakça
- Beardsall K, Diderholm BM, Dunger DB. Insulin and carbohydrate metabolism. Best Pract Res Clin Endocrinol Metab 2008; 22: 41-55.
- Mulvihill SJ, Stone MM, Debas HT, Fonkalsrud EW. The role of amniotic fluid in fetal nutrition. J Pediat Surg 1985; 20: 668-72.
- Reece EA. The fetal and maternal consequences of gestational diabetes mellitus. J Matern Fetal Neonatal Med 2010; 23: 199-203.
- Boisvert MR, Koski KG, Skinner CD. Increased oxidative modifications of amniotic fluid albumin in pregnancies associated with gestational diabetes mellitus. Anal Chem 2010; 82: 1183-7.
- Taricco E, Radaelli T, Rossi G, Nobile de Santis MS, Bulfamante GP, Avagliano L, Cetin I. Effects of gestational diabetes on fetal oxygen and glucose levels in vivo. BJOG 2009; 116: 1729-35.
- Pappa KI, Anagnou NP, Salamalekis E, Bikouvarakis S, Maropoulos G, Anogianaki N, Evangeliou A, Koumantakis E. Gestational diabetes exhibits lack of carnitine deficiency despite relatively low carnitine levels and alterations in ketogenesis. J Matern Fetal Neonatal Med 2005; 17: 63-8.
- Roberts JM, Bodnar LM, Lain KY, Hubel CA, Markovic N, Ness RB, Powers RW. Uric acid is as important as proteinuria in identifying fetal risk in women with gestational hypertension. Hypertension 2005, 46: 1263-9.
- Carpenter MW, Canick JA, Hogan JW, Shellum C, Somers M, Star JA. Amniotic fluid insulin at 14-20 weeks' gestation: association with later maternal glucose intolerance and birth macrosomia. Diabetes Care 2001; 24: 1259-63.
- Henson MC, Castracane VD. Leptin in pregnancy: an update. Biol Reprod 2006; 74: 218-29.
- Tisi DK, Burns DH, Luskey GW, Koski KG. Fetal exposure to altered amniotic fluid glucose, insulin, and insulin-like growth factor-binding protein 1 occurs before screening for gestational diabetes mellitus. Diabetes Care 2011; 1: 139-44.
- Carpenter MW, Canick JA, Star J, Carr SR, Burke ME, Shahinian K. Fetal hyperinsulinism at 14-20 weeks and subsequent gestational diabetes. Obstet Gynecol 1996; 87: 89-93.
- D'Anna R, Baviera G, Cannata ML, De Vivo A, Di Benedetto A, Corrado F. Midtrimester amniotic fluid leptin and insulin levels and subsequent gestational diabetes. Gynecol Obstet Invest 2007; 64: 65-8.
- Star J, Canick JA, Palomaki GE, Carpenter MW, Saller DN Jr, Sung CJ, Tumber MB, Coustan DR. The relationship between second-trimester amniotic fluid insulin and glucose levels and subsequent gestational diabetes. Prenat Diagn 1997; 17: 149-54.
- Weerasiri T, Riley SF, Sheedy MT, Walstab JE, Wein P. Amniotic fluid insulin values in women with gestational diabetes as a predictor of emerging diabetes mellitus. Aust N Z J Obstet Gynaecol 1993; 33: 358-61.
- Oktem O, Dedeoğlu N, Oymak Y, Sezen D, Köksal L, Pekin T, Gökaslan H, Kavak ZN. Maternal serum, amniotic fluid and cord leptin levels at term: their correlations with fetal weight. J Perinat Med 2004; 32: 266-71.
- Cagnacci A, Arangino S, Caretto S, Mazza V, Volpe A. Sexual dimorphism in the levels of amniotic fluid leptin in pregnancies at 16 weeks of gestation: relation to fetal growth. Eur Obstet Gynecol Reprod Biol; 2006; 124: 53-7.
Öz
Amaç. Bu çalışmanın amacı midtrimester amniyotik sıvıda leptin ve insülin düzeylerini inceleyerek bunların daha sonraki dönemde gestasyonel diabetes mellitus gelişen olguları tahmin etmede faydalı olup olamayacağını araştırmaktır. Yöntem. Genetik amniyosentezle 16-20 haftalık gebelerden alınan amniyotik sıvı örneklerinde leptin ve insülin düzeylerini araştırdık. Prospektif takiplerde gestasyonel diabetes mellitusta gelişen ve sağlıklı gebelik sürdüren hastaları kaydettik. Bulgular. Gestasyonel diabetes mellitus gelişen grupta amniyotik sıvı leptin (17,3 ng/mL) ve insülin (3,4 ng/mL) düzeyleri kontrol grubunun amniyotik sıvı leptin (10,1 ng/mL) ile amniyotik sıvı insülin (1,7 ng/dL) düzeylerine göre istatistiksel olarak yüksek bulunmuştur. Sonuç. Amniyotik sıvı’da henüz gestasyonel diabetes mellitus bulguları ortaya çıkmadan leptin ve insülin düzeylerinin yüksek bulunması bu proteinlerin gestasyonel diabetes mellitusu önceden tahmin etmede kullanılabileceği kanısını vermektedir.
Anahtar Kelimeler
Kaynakça
- Beardsall K, Diderholm BM, Dunger DB. Insulin and carbohydrate metabolism. Best Pract Res Clin Endocrinol Metab 2008; 22: 41-55.
- Mulvihill SJ, Stone MM, Debas HT, Fonkalsrud EW. The role of amniotic fluid in fetal nutrition. J Pediat Surg 1985; 20: 668-72.
- Reece EA. The fetal and maternal consequences of gestational diabetes mellitus. J Matern Fetal Neonatal Med 2010; 23: 199-203.
- Boisvert MR, Koski KG, Skinner CD. Increased oxidative modifications of amniotic fluid albumin in pregnancies associated with gestational diabetes mellitus. Anal Chem 2010; 82: 1183-7.
- Taricco E, Radaelli T, Rossi G, Nobile de Santis MS, Bulfamante GP, Avagliano L, Cetin I. Effects of gestational diabetes on fetal oxygen and glucose levels in vivo. BJOG 2009; 116: 1729-35.
- Pappa KI, Anagnou NP, Salamalekis E, Bikouvarakis S, Maropoulos G, Anogianaki N, Evangeliou A, Koumantakis E. Gestational diabetes exhibits lack of carnitine deficiency despite relatively low carnitine levels and alterations in ketogenesis. J Matern Fetal Neonatal Med 2005; 17: 63-8.
- Roberts JM, Bodnar LM, Lain KY, Hubel CA, Markovic N, Ness RB, Powers RW. Uric acid is as important as proteinuria in identifying fetal risk in women with gestational hypertension. Hypertension 2005, 46: 1263-9.
- Carpenter MW, Canick JA, Hogan JW, Shellum C, Somers M, Star JA. Amniotic fluid insulin at 14-20 weeks' gestation: association with later maternal glucose intolerance and birth macrosomia. Diabetes Care 2001; 24: 1259-63.
- Henson MC, Castracane VD. Leptin in pregnancy: an update. Biol Reprod 2006; 74: 218-29.
- Tisi DK, Burns DH, Luskey GW, Koski KG. Fetal exposure to altered amniotic fluid glucose, insulin, and insulin-like growth factor-binding protein 1 occurs before screening for gestational diabetes mellitus. Diabetes Care 2011; 1: 139-44.
- Carpenter MW, Canick JA, Star J, Carr SR, Burke ME, Shahinian K. Fetal hyperinsulinism at 14-20 weeks and subsequent gestational diabetes. Obstet Gynecol 1996; 87: 89-93.
- D'Anna R, Baviera G, Cannata ML, De Vivo A, Di Benedetto A, Corrado F. Midtrimester amniotic fluid leptin and insulin levels and subsequent gestational diabetes. Gynecol Obstet Invest 2007; 64: 65-8.
- Star J, Canick JA, Palomaki GE, Carpenter MW, Saller DN Jr, Sung CJ, Tumber MB, Coustan DR. The relationship between second-trimester amniotic fluid insulin and glucose levels and subsequent gestational diabetes. Prenat Diagn 1997; 17: 149-54.
- Weerasiri T, Riley SF, Sheedy MT, Walstab JE, Wein P. Amniotic fluid insulin values in women with gestational diabetes as a predictor of emerging diabetes mellitus. Aust N Z J Obstet Gynaecol 1993; 33: 358-61.
- Oktem O, Dedeoğlu N, Oymak Y, Sezen D, Köksal L, Pekin T, Gökaslan H, Kavak ZN. Maternal serum, amniotic fluid and cord leptin levels at term: their correlations with fetal weight. J Perinat Med 2004; 32: 266-71.
- Cagnacci A, Arangino S, Caretto S, Mazza V, Volpe A. Sexual dimorphism in the levels of amniotic fluid leptin in pregnancies at 16 weeks of gestation: relation to fetal growth. Eur Obstet Gynecol Reprod Biol; 2006; 124: 53-7.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Cerrahi Tıp Bilimleri Araştırma Yazıları |
| Yazarlar | |
| Yayımlanma Tarihi | 21 Haziran 2012 |
| Yayımlandığı Sayı | Yıl 2012Cilt: 34 Sayı: 2 |