Leptin and metabolic hormones in preterm newborns
P C Nga, C W K Lamb, C H Leea, G W K Wonga, T F Foka, I H S Chanb, K C Maa, E Wongc
a Department of
Paediatrics, Level 6, Clinical Sciences Building, Prince of Wales
Hospital, Chinese University of Hong Kong, Shatin, NT, Hong Kong, b Department of Chemical Pathology,
Prince of Wales Hospital, c Center for Clinical Trials and Epidemiological
Research, Prince of Wales Hospital
Correspondence to: Prof. Ng pakcheungng{at}cuhk.edu.hk
Accepted 16 June 2000
AIM
To investigate the
inter-relation between leptin and other metabolic hormones in preterm
and term infants and to explore whether a functional "adipoinsular
axis" might exist in preterm newborns.
METHODSA total of 140 preterm and
term newborns were prospectively recruited and categorised according to
gestation length. Blood samples were taken at 24 hours (day 1), and on
day 4-5 of life.
RESULTSSerum leptin, cortisol,
free thyroxine, and plasma ACTH on day 1 were significantly higher in
term than in preterm infants. The relation between serum leptin and
gestation followed a non-linear pattern; the slope of the curve began
to increase steeply between 33 and 35 weeks gestation. Serum leptin on
day 1 was significantly associated with serum insulin, insulin:glucose
ratio, and plasma ACTH in infants less than 34 weeks gestation; serum
leptin on day 1 and day 4-5 were significantly correlated with
insulin:glucose ratio in infants 34 or more weeks gestation.
Significant changes in the pattern of metabolic hormones were observed
in the first week of life. Serum insulin and plasma glucose were
significantly increased between day 1 and day 4-5; serum leptin was
significantly decreased.
CONCLUSIONSThe circulating leptin
concentration increases markedly after 34 weeks gestation and bears a
close temporal relation with the exponential accumulation of body fat
mass during that period. The inter-relation between serum leptin and
insulin or insulin:glucose ratio before and after 34 weeks gestation
indicates that the "adipoinsular axis" is likely to be functional
in early (<34 weeks gestation) intrauterine life. The rapid decline in
the circulating concentrations of leptin after birth may be of
physiological advantage to preterm and term newborns by limiting their
body energy expenditure and conserving nutritional reverses for
subsequent growth and development.
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Key message
Serum leptin increases considerably after 34 weeks gestation and bears a close temporal relation with the rapid accumulation of body fat mass during late gestation. The association between serum leptin and insulin or insulin:glucose ratio suggests that the "adipoinsular axis" is likely to be functional in early (less than 34 weeks gestation) intrauterine life |
Keywords: leptin; adipoinsular axis
© 2000 by Archives of Disease in Childhood
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