Leptin levels and antihypertensive treatment in preeclampsia.

INTRODUCTION This study was carried out to investigate changes in the plasma leptin concentrations during preeclampsia treatment and to determine whether antihypertensive treatments, aimed at decreasing leptin levels, would improve foetal outcomes. METHODS A prospective study was undertaken in 57 pregnant women with preeclampsia (37 with mild and 20 with severe preeclampsia) and 46 normal pregnant women who were matched in maternal and gestational age and body mass index. The mild preeclampsia group was treated with alpha-methyldopa, while the severe preeclampsia group was treated with a combination of alpha-methyldopa and nifedipine. RESULTS The severe preeclampsia group had significantly lower platelet counts, higher systolic and diastolic blood pressures and elevated serum uric acid concentrations. Pre-treatment plasma leptin levels were significantly increased in the severe preeclampsia group (range 18.3-49.5) compared to the the mild preeclampsia group (range 20.7-45.4) and normal controls (range 8.6-19.2). Post-treatment plasma leptin levels in both the mild and severe preeclampsia groups (range 10.2-23.5 and 11.3-24.4, respectively) were statistically similar to those of the control group (range 9.1-20.7). Estimated foetal weight, intrauterine growth retardation and demise were statistically similar in the three study groups. CONCLUSION Plasma leptin concentrations were found to be elevated in women diagnosed with severe preeclampsia. However, the exact mechanism underlying the increased plasma leptin levels in preeclampsia and the functional role of leptin in the development of hypertension need to be further clarified. Leptin has a promising future as a valuable marker to identity women with a high risk for preeclampsia.