Leptin-Mediated Inflammation and Antioxidant Response in Hyperemesis Gravidarum: Evidence of a Protective Shift in Early Pregnancy

Abstract

Introduction: Hyperemesis gravidarum (HG) is a condition of intractable vomiting during pregnancy, leading to fluid, electrolyte and acid–base imbalance, nutritional deficiency and weight loss. Leptin is known to regulate appetite, but its association with oxidative stress and inflammation in HG has not been fully elucidated Aim: To assess serum leptin, oxidative stress and inflammatory markers and their correlation in pregnant women with hyperemesis gravidarum Study Design: This is a cross-sectional case-control study. Place and Duration of Study: Ante-Natal Clinic, General Hospital, Ifo, Ogun State, between April and June, 2022. Methodology: A total of ninety participants were recruited for the study. This consists of 45 pregnant women with hyperemesis gravidarum and 45 apparently healthy pregnant women (without hyperemesis gravidarum) who served as controls. The serum samples obtained from study participants were assayed for serum leptin, high sensitivity C reactive-protein (hsCRP), Malondialdehyde, Total antioxidant status and Glutathione peroxidase using Enzyme Linked Immunosorbent Assay and Colorimetric methods. Results: Mean serum leptin levels were significantly higher in the hyperemesis gravidarum group compared to controls (6.1 ± 1.26 vs. 5.0  ± 1.14 ng/mL; p < 0.01). High sensitivity C-Reactive Protein was also significantly elevated in hyperemesis gravidarum (9.48 ± 2.12 vs. 6.12 ± 1.24 mg/L; p < 0.005), indicating a pro-inflammatory state. Total antioxidant status was higher in the hyperemesis gravidarum group (3.12 ± 0.74 vs. 2.45 ± 0.65; p < 0.05), alongside elevated glutathione peroxidase (110.74 ± 27.1 vs. 93.17 ± 18.9 μ/mL; p < 0.005). No significant difference was observed in Malondialdehyde levels between the groups (7.59 ± 2.8 vs. 8.03 ± 3.05 nmol/mL; p > 0.05). Conclusion: Hyperemesis gravidarum is associated with elevated leptin and hsCRP levels, suggesting an inflammatory component. The concurrent rise in TAS and GPx, despite stable MDA levels, indicates a compensatory antioxidant response rather than overt oxidative damage. These findings highlight leptin's possible role in modulating inflammation and redox balance during early pregnancy.