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Gestational weight gain, appetite regulating hormones, and metformin treatment in polycystic ovary syndrome: A longitudinal, placebo-controlled study
Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Department of Obstetrics and Gynaecology, St Olav's Hospital, Trondheim University Hospital, Trondheim, Norway.
Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Department of Obstetrics and Gynaecology, St Olav's Hospital, Trondheim University Hospital, Trondheim, Norway.
Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
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2022 (Engelska)Ingår i: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 129, nr 7, s. 1112-1121Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objective: To explore mechanisms that modulate gestational weight gain (GWG) in women with polycystic ovary syndrome (PCOS) and healthy controls.

Design: Sub-sample of randomised controlled trials (PCOS) combined with a prospective cohort (controls).

Setting: Eleven Norwegian, Swedish, and Icelandic hospitals.

Population: Pregnant women with PCOS treated with metformin (PCOS-M, n = 36) or placebo (PCOS-P, n = 37), and healthy pregnant women (HC, n = 15).

Methods: Serum levels of the appetite regulating hormones leptin, ghrelin, allopregnanolone, and soluble leptin receptor (sOB-R) were determined in the first and third trimesters.

Main Outcome Measures: Excessive GWG (eGWG) relative to body mass index according to Institute of Medicine (IOM) guideline. Serum leptin/sOB-R ratio, or free-leptin-index (FLI), as biomarker of leptin sensitivity. Serum ghrelin and allopregnanolone levels.

Results: The overall prevalence of eGWG was 44% (38/86). Women with eGWG had higher first and third trimester FLI (< 0.001), and lower third trimester allopregnanolone levels (= 0.003) versus women with non-eGWG. The prevalence of eGWG was lower in PCOS-M versus PCOS-P (28% versus 62%, odds ratio = 0.4, 95% CI 0.2–0.8, = 0.005). FLI decreased during pregnancy in PCOS-M (= 0.01), but remained unaltered in PCOS-P and HC. Ghrelin and allopregnanolone levels were comparable in PCOS-M, PCOS-P and HC throughout pregnancy.

Conclusion: Excessive GWG is associated with enhanced leptin resistance, and attenuated physiological increase in serum allopregnanolone levels during pregnancy. Metformin reduces the risk for eGWG and improves leptin sensitivity in pregnant women with PCOS.

Ort, förlag, år, upplaga, sidor
John Wiley & Sons, 2022. Vol. 129, nr 7, s. 1112-1121
Nationell ämneskategori
Reproduktionsmedicin och gynekologi
Identifikatorer
URN: urn:nbn:se:umu:diva-191090DOI: 10.1111/1471-0528.17042ISI: 000734689400001PubMedID: 34865304Scopus ID: 2-s2.0-85122031307OAI: oai:DiVA.org:umu-191090DiVA, id: diva2:1627722
Forskningsfinansiär
Region Västerbotten, 310426013Norges forskningsråd, 213497Tillgänglig från: 2022-01-14 Skapad: 2022-01-14 Senast uppdaterad: 2022-07-12Bibliografiskt granskad

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Molin, JohannaDehlin, EvaBixo, Marie

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