SERUM LEPTIN LEVELS AS A MARKER FOR SEVERITY OF PRE-ECLAMPSIA
Introduction: Pre-eclampsia is one of the most common clinical conditions seen in high risk pregnancies with 7-10%
complication rate. Preeclampsia is characterized by hypertension and arteriolar vasoconstriction which decreases
the uteroplacental perfusion and results in placental hypoxia. Long lasting placental hypoxia can in turn lead to fetal
growth retardation. Under the control of the Obesity gene, the adipose tissues and placental trophoblasts synthesize
and secrete a protein called leptin. Leptin binds to receptors to initiate a cascade of biological processes involved
in regulating food intake and energy expenditure. Leptin has been implicated in the pathogenesis of pre-eclampsia.
Objective: To determine the role of serum leptin levels as a marker for severity of Preeclampsia.
Material and Methods: This study was conducted at Gynae OPD Hayatabad Medical Complex and Lady Reading
hospital Peshawar for a period of 6 months. This was a case control study in which the sample size was 80 subjects.
These were divided into two groups, 40 cases and 40 controls. Inclusion criteria include all patients with mild and severe
pre-eclampsia having gestational age more than 20 weeks.
Exclusion criteria were twin pregnancies, patients having heart disease or kidney disease and gestational age of
less than 20 weeks. Leptin level in serum was estimated by ELISA, and proteinuria by dipstick method.
Results: Total of 80 subjects (40 cases and 40 controls) participated in this trial as per inclusion and exclusion criteria.
Cases were divided into mild & severe pre-eclampsia. The mean age of cases was 27 years and controls were 24.9
years. Mean period of gestation of both cases and controls was 35.3 weeks. Mean B.P of cases was 153/100 mmHg,
while that of controls was 111/75mmHg. The mean leptin levels were 9.57 ng/ml in controls. In mild pre-eclampsia,
leptin levels were 25.57 ng/ml and in severe pre-eclampsia, the levels were 36.47 ng/ml. Serum levels of leptin were
found to be significantly associated with severity of pre-eclampsia. Risk estimation showed that each 15 ng/ml increase
in severe leptin levels will increase the risk of pre-eclampsia by four fold (OR=4.9) Reference range of leptin levels in
normal pregnancy was found to be 8-11 ng/ml. In mild pre-eclampsia it was found to be 21-30 ng/ml while in severe
pre-eclampsia, the range was 33-40 ng/ml.
Conclusion: From this comparative study it is concluded that serum leptin levels may be used as a marker for severity.