Relationship of Serum Leptin, Lactate Dehydrogenase Levels and Severity in Preeclampsia

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DOI: 10.21522/TIJAR.2014.03.01.Art030

Authors : Uma Devi Kantipudi, Sheela SR, Dayanand CD, Nagarjuna Sivaraj


Aim: To assess whether Serum Leptin and Lactate dehydrogenase levels as an indication of severity in preeclampsia. Study Design: A prospective case control study, consist of two groups such as group 1 normotensive Pregnants and group 2 as cases with clinically diagnosed preeclampsia Place and Duration of Study: Department of Obstetrics and Gynaecology, RL Jalappa Hospital and Research Centre and Proteomics laboratory kolar, between January 2013 and July 2014. Methodology: A total number of 100 pregnant patients were enrolled in the present study. Amongst, normotensive and preeclamptic pregnant women Group 1 (n=50) as controls (n=50). Group-2 (n=50) were preeclampsia cases. Five ml of blood samples were collected from each normal pregnant and preeclampsia patients. Leptin levels and lactate dehydrogenase parameters were estimated using ELISA -Micro plate Reader method. Statistical analysis analysed by using SPSS Software. Results: The Mean ± SD values of Lactate dehydrogenase IU/L (399.04±113.08) and Leptinng/ml (9.02±4.65) in normal pregnant and Lactate dehydrogenase IU/L (1296.68±1732.95), Leptin ng/ml (23.32±8.78) in preeclampsia cases were presented. Similarly Mean ± SD values in preeclampsia were presented respectively. Conclusion: The elevated serum leptin levels in preeclampsia indicate endothelial dysfunction involved in the pathogenesis of preeclampsia. The relationship of serum leptin and Lactate dehydrogenase levels were increased in preeclampsia that is directly proportional to gestational age in last trimester. These biochemical parameters were significantly elevated in severe preeclampsia, mild preeclampsia and compared to normal pregnancy. Identification of high-risk patients with elevated levels of serum lactate dehydrogenase and Leptin necessitate the close monitoring for prompt and correct management which may decrease the complications of disease condition and also facilitate to reduce maternal and fetal morbidity and mortality.


[1.] Cindrova-Davies T. Gabor Than award lecture 2008: preeclampsia-From placental Oxidative stress to maternal endothelial dysfunction. Placenta 2009; 30:55-65.

[2.] Von Dadleszen, P. Mageela, Taylor, Muir J C, Stewart SD, et al. Maternal hypertension and neonatal outcome among small for gestational age infants. Obstet Gynecol 2005; 106:335-39.

[3.] Cunningham F G, Leveno KJ, Bloom SL, Hauth J C, Gilstrap D J, Wenstrom S Y. Williams Obstetrics. 23rd Edition. McGraw Hill Medical Publishing Division 2010; section VII, 34: 706-56.

[4.] Mutlu T U, Ademoglu E. Imbalance between lipid peroxidation, antioxidant status in preeclampsia. Gynecol Obstet Invest 1998; 46: 37-40.

[5.] Maternal mortality in 2005: estimates developed by WHO, UNICEF, UNIFPA and the World Bank, Geneva, World Health Organization, 2007.

[6.] World Health Organization Fact Sheet, May 2012.

[7.] Kathleen A. Pennington, Jessica M. Schlitt, Daniel L .Jackson, Laura C. Schulz and Danny J. Schust: Preeclampsia: Multiple approaches for a multifactorial disease, disease models and mechanisms 5, 9­18(2012).

[8.] Misra A, Khurana L. Obesity and the metabolic syndrome in developing countries. J. of Clin Endo and Metabolism

[9.] Ursula M, Axel M. Gressner: Endocrine regulation of energy metabolism, clinchemis 50:9 1511-1525 (2004).

[10.] Malarewicz A, Gruszka O, Szymkiewicz J, RogalaJ. The usefulness of routine laboratory tests in the evaluation of sudden threat of pregnant woman and the fetus in preeclampsia. Ginekol Pol 2006.,77(4):276­84.

[11.] Procopciuc LM, Hazi GM, Caracostea G: Correlation between the TSHRc Asp727Glu polymorphism and plasma thyroid stimulating hormone levels in Romanian preeclamptic women. Gynecol Endocrinol. 2011; 27(4): 225-231.

[12.] Naglaa G, Ashraf D, Rania A, and Alaa El H: “Evaluation of serum Leptin and Androgens Levels in Preeclampsia: Relation with Disease Severity”. J. American sci 2011. 7(9):366-372.

[13.] Rubina A, Tabassum M: “Relation between Preeclampsia and Cardiac Enzymes” J. ARYA Atherosclerosis 2008, 4(1): 29-32.

[14.] Yadav S, Yadav R, Saxena U. Hypertensive disorders of pregnancy and perinatal outcome. J. Obset. Gynecol. Ind. 1997; 17: 322-30

[15.] Coonrod D V, Hickok DE, Zhu K, Easterling T R, Daling JR. Risk factors for Pre-eclampsia in twin pregnancies: a population-based cohort study. Obstet Gynecol 1995; 85:645-50.

[16.] Eskenazi B, Fenster L, Sidney SA. Multivariate analysis of risk factors for Pre-eclampsia. J Am Med Assoc 1991; 266:237­41.

[17.] Stone J L, Lockwood CJ, Berkowitz GS, Alvarez M, Lapinski R, Berkowitz RL. Risk factors for severe Pre-eclampsia. Obstet Gynecol 1994; 83:357-61.

[18.] Chen CL, Cheng Y, Wang PH, Juang CM, Chiu LM, Yang MJ, et al. Review of pre-eclampsia in Taiwan: a multi-institutional study. Zhonghua Yi Xue Za Zhi (Taipei) 2000; 63:869-75.

[19.] Odegard RA, Vatten L J, Nilsen S T, Salvesen K A, Austgulen R. Risk factors and clinical manifestations of pre-eclampsia. Br J Obstet Gynecol 2000; 107:1410-6.

[20.] Stamilio DM, Sehdev HM, Morgan MA, Propert K, Macones GA. Can antenatal clinical and biochemical markers predict the development of severe Pre-eclampsia? Am J Obstet Gynecol 2000; 182: 589-94.

[21.] Salvatores M, Gennarelli G, Menato G, Massobrio M, Leptin as a possible marker of augmented metabolic risk during pregnancy. Minerva Ginecol 2006; 58(1):1-10.

[22.] Singh, H.J.; Abu Bakar, A.; CheRomli, A. and Nila, A. (2005): Raised leptin concentrations in feto-placental tissues from women with preeclampsia. Hypertens Pregnancy; 24(2): 191-199.

[23.] Laml, T.; Preyer, O.; Hartmann, B.W.; Ruecklinger, E.; Soeregi, G. and Wagenbichler, P. (2001): Decreased maternal serum leptin in pregnancies complicated by preeclampsia. J Soc Gynecol Invest; 8(2): 89-93.

[24.] Mise, H.; Sagawa, N.; Matsumoto, T.; Yura, S.; Nanno, H.; Itoh, H.; Mori, T.; Masuzaki, H.; Hosoda, K.; Ogawa, Y. and Nakao, K. (1998): Augmented placental production of leptin in pre-eclampsia: possible involvement of placental hypoxia. J. of Clin Endo and Metabolism; 83: 3225-3229.

[25.] SebihaOzkan; Cemal Tamer Erel; Riza Madazli and Kilic Aydinli (2005): Serum leptin levels in hypertensive disorder of pregnancy. Eur J. of Obstet and Gynecol and Reprod Biol; 120: 158-163.

[26.] Bartha, J. L.; Romero-Carmona, R.; Escobar-Llompan, M. and Comino-Del-gado, R. (2001): The relationships between leptin and inflammatory cytokines in women with preeclampsia. BJOG; 108(12): 1272-6.

[27.] Qublan HS, Ammarin V, Bataineh O, Al Shraideh Z, Tahat Y, Awamleh I, et al. Lactic dehydrogenase as a biochemical marker of adverse pregnancy outcome in severe pre-eclampsia. Med Sci Monit 2005; 11(8): CR393-CR397.

[28.] He S, Bremme K, Kallner A, et al. Increased concentrations of lactate dehydrogenase in pregnancy with Preeclampsia; a predictor for birth of small for gestational age infants. Gynecol Obstet Invest. 1995; 39:234-8.

[29.] Martin J N Jr, May WL, Magann E F, et al. Early risk assessment of severe Preeclampsia: admission battery of symptoms and laboratory tests to predict likelihood of subsequent significant maternal morbidity. Am J Obstet Gynecol. 1999; 180:1407-14.

[30.] Demir SC, Evruke C, Ozgunen FT, et al. Factors that influence morbidity and mortality in severe preeclampsia, eclampsia and HELLP syndrome. Saudi Med J. 2006; 27:1015-18.

[31.] Hall DR, Odendaaal H J, Kirsten G F, et al. Expectant Management of early onset, severe preeclampsia perinatal outcome. BJOG. 2000; 107:1258-64.