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Leptin and bone turnover in monochorionic twins complicated by twin–twin transfusion syndrome

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Abstract

Introduction

To test the hypothesis that the bone metabolism of a growth-restricted foetus is regulated by genetic, placental and/or foetal factors through leptin, we investigated the foetal bone turnover in monochorionic pregnancies complicated with or without twin–twin transfusion syndrome (TTTS).

Methods

Maternal and cord bloods were collected from gestational-age-matched monochorionic twins with (n = 15) and without (n = 15) TTTS. The samples were assayed for leptin, cross-linked carboxyl terminal telo-peptide (ICTP, a marker of bone resorption) and pro-peptide (PICP, a marker of bone formation) of type I collagen by radioimmunoassay (RIA).

Results

In the growth-restricted donor twin, the plasma concentration of leptin (P < 0.001), PICP (P < 0.001) was lower, while that of ICTP (P < 0.001) was higher than the recipient twin of the TTTS group. In contrast, leptin, PICP and ICTP were comparable in non-TTTS twins. In the recipient twin of TTTS and non-TTTS twins, leptin was positively associated with PICP (r = 0.73; n = 45, P < 0.001) and negatively with ICTP (r = −0.68; n = 45; P < 0.001). No such association was found between leptin and bone marker in the growth-restricted donor twin of the TTTS group.

Conclusion

Our data suggest that, in AGA twins, leptin maintains bone metabolism by inhibiting resorption and enhancing bone formation. In contrast, growth-restricted donor twins have high bone turnover and this does not seem to be due to leptin deficiency.

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Authors and Affiliations

  1. Academic Unit of Obstetrics and Gynaecology, St. Mary’s Hospital, Manchester, UK

    R. Bajoria

  2. Department of Maternal and Foetal Medicine, Chelsea and Westminster Hospital, London, UK

    S. R. Sooranna

  3. Department of Obstetrics and Gynaecology, University College London, London, UK

    R. Chatterjee

  4. Newham General University Hospital, Glen Road, Plaistow, London, E16, UK

    R. Bajoria

Authors
  1. R. Bajoria
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  2. S. R. Sooranna
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  3. R. Chatterjee
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Correspondence to R. Bajoria.

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Bajoria, R., Sooranna, S.R. & Chatterjee, R. Leptin and bone turnover in monochorionic twins complicated by twin–twin transfusion syndrome. Osteoporos Int 18, 193–200 (2007). https://doi.org/10.1007/s00198-006-0236-5

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  • DOI: https://doi.org/10.1007/s00198-006-0236-5

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