The Comparison of Maternal and Fetal Insulin, C Peptide and Insulin-Like Growth Factor 1 Concentration in Healthy and Pregnant Women with Gestational Diabetes and Their Correlation with Neonatal Birth Weight

Document Type : Original Article

Authors

1 Associate Professor, Department of Obstetrics and Gynecology, High Risk Pregnancy Research Center, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.

2 Professor, Department of Clinical Biochemistry, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.

3 Resident, Department of Obstetrics and Gynecology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Abstract

Introduction: The insulin levels, insulin-like growth factors and C-peptide have effects on the progression of fetal growth. There are controversial results about the effects of these parameters on fetal growth. This study for the first time had investigated the serum levels of IGF-1, insulin and C-peptide simultaneously both in mothers with gestational diabetes and in their infants compared to healthy pregnant women and has determined their conflation with infant's weight.
Methods: This analytical cross sectional study was conducted on 85 healthy and diabetic pregnant women hospitalized in Imam Reza hospital of Kermanshah, Iran in 2010-2011 at the time of delivery. Fasting blood samples were obtained from mothers and cord venous blood samples were obtained immediately after birth. The serum levels of IGF-1, insulin and C-peptide were determined by ELISA method. Data were analyzed using SPSS software version 16, independent t-test, Mann-Whitney u and Pearson correlation coefficient tests. P value less than 0.05 was considered significant.
Results: The serum levels of IGF-1 in diabetic mothers and in their infants was significantly correlated with infants birth weight (p=0.043, p=0.028). But other measured parameters in healthy and diabetic mothers were not significantly associated with birth weight.
Conclusion: Serum level of IGF-1 in mothers with gestational diabetes and in their newborn is correlated to infant's birth weight.

Keywords


  1. Qiu C, Vadachkoria S, Meryman L, Frederick IO, Williams MA. Maternal plasma concentrations of IGF-1, IGFBP-1, and C-peptide in early pregnancy and subsequent risk of gestational diabetes mellitus. Am J Obstet Gynecol 2005 Nov;193(5):1691-7.
  2. Di Cianni G, Miccoli R, Volpe L, Lencioni C, Delprato S. Intermediate metabolism in normal pregnancy and in gestational diabetes. Diabetes Metab Res Rev 2003 Jul-Aug;19(4):259-70.
  3. Lindsay RS, Westgate JA, Beattie J, Pattison NS, Gamble G, Mildenhall LF, et al. Inverse changes in fetal Insulin-like growth factor (IGF)-1 and IGF binding protein-1 in association with higher birth weight in maternal diabetes. Clin Endocrinol (Oxf) 2007 Mar;66(3):322-8.
  4. Arend N, Johnston L, Hokken-Koelega A, van Duijn C, de Ridder M, Savage M, et al. Polymorphism in the IGF-1 gene: clinical relevance for short children born small for gestational age (SGA). J Clinl Endocrinol Metab 2002 Jub;87(6):2720.
  5. Luo ZC, Nuyt AM, Delvin E, Audibert F, Girard I, Shatenstein B, et al. Maternal and fetal IGF-1 and IGF-II levels, fetal growth, and gestational diabetes. J Clin Endocrinol Metab 2012 May;97(5):1720-8.
  6. Czeszynska M, Janus D, Pankiewicz E, Konefal H, Hantyszyn G. Gestational diabetes: cord blood insulin, IGF-1 and IGF-II levels in relation to anthropometric parameters of neonates born as aga or LGA. Pediatr Res 2005;87:367.
  7. Jiang H, Xun P, Luo G, Wang Q, Cai Y, Zhang Y, et al. Levels of insulin-like growth factors and their receptors in placenta in relation to macrosomia. Asia Pac J Clin Nutr 2009;18(2):171-8.
  8. Lauszus.F,Kiebe.J,Flyvbyerg.A,Increased serum IGF1 during pregnancy is associated with progression of diabetic retinopathy,Diabetes,2003,52(3),pp:852-6
  9. Akcakus M, Koklu E, Kurtoglu S, Kula M, Koklu SS. The relationship among intrauterine growth, insulin like growth factor I (IGF-I), IGF-binding protein-3, and bone mineral status in newborn infants. Am J Perinatol 2006 Nov;23(8):473-80.
  10. Martínez-Cordero C, Amador-Licona N, Guízar-Mendoza JM, Hernández-Mendez J, Ruelas-Orozco G. Body fat at birth and cord blood levels of insulin, adiponectin, leptin, and insulin-like growth factor-I in small-for-gestational-age infants. Arch Med Res 2006 May;37(4):490-4.
  11. Jaksić J, Mikulandra F, Perisa M, Miletić T, Dubovecak Z, Skugor D, et al. Effect of insulin and insulin-like growth factor I on fetal macrosomia in healthy women. Coll Antropol 2001 Dec;25(2):535-43.
  12. Wiznitzer A, Furman B, Zuili I, Shany S, Reece E, Mazor M. Cord leptin level and fetal macrosomia. Obstet Gynecol 2000 Nov;96(5):707-13.
  13. Di Biase N, Napoli A, Caiola S, Buongiorno AM, Maroccia E, Sabbatini A, et al. IGF-1 levels in diabetic pregnant women and their infants. Ann Ist Super Sanita 1997;33(3):379-82.
  14. Susa JB, Widness JA, Hintz R, Liu F, Sehgal P, Schwartz R, Somatomedins and insulin in diabetic pregnancies: effects on fetal macrosomia in the human and rhesus monkey. J Clin Endocrinol Metab 1984 Jun;58(6):1099-105.
  15. Lauszus.F,The clinical significance of IGF1 in maternal serum during pregnancy in type1 diabetes,curr diabetes rev,2007,3(3),pp:194-7
  16. Verhaeghe J, Van Bree R, Van Herck E, Laureys J, Bouillon R, Van Assche FA, C-peptide, insulin-like growth factors I and II, and insulin-like growth factor binding protein-1 in umbilical cord serum: correlations with birth weight. Am J Obstet Gynecol 1993 Jul;169(1):89-97.
  17. Fuglsang J, Lauszus F, Flyvbjerg A, Ovesen P. Human placental growth hormone, insulin-like growth factor I and -II, and insulin requirements during pregnancy in type 1 diabetes. J Clin Endocrinol Metab 2003 Oct;88(10):4355-61.
  18.  Martos-Moreno GÁ, Barrios V, Saenz de Pipaon M, Pozo J, Dorronsoro I, Martinez-Biarge M, et al. Influence of prematurity and growth restriction on the adipokine profile, IGF1, and ghrelin levels in cord blood: relationship with glucose metabolism. Eur Endocrinol 2009 Sep;161(3);381-9.
  19. Roth S, Abernathy MP, Lee WH, Pratt L, Denne S, Golichowski A, et al. Insulin-like growth factors I and II peptide and messenger RNA levels in macrosomic infants of diabetic pregnancies. J Soc Gynecol Investig 1996 Mar;3(2):78-84.
  20. Wiznitzer A, Recce EA, Homko C, Furman B, Mazor M, Levy J. Insulin-like growth factors their binding proteins, and fetal macrosomia in offspring of nondiabetic pregnant women. Am J Perinatol 1998 Jan;15(1):23-8.
  21. Matuszek B, Lenart-Lipinska M, Burska A, Paszkowski T, Smolen A, Nowakowski A, Increased serum insulin-like growth factor-1 levels in women with gestational diabetes. Adv Med Sic 2011;56(2):200-6.
  22. Tisi DK, Burns DH, Luskey GW, Koski KG. Fetal exposure to altered amniotic fluid glucose, insulin, and insulin-like growth factor-binding protein 1 occurs before screening for gestational diabetes mellitus. Diabetes Care 201l Jan;34(1):139-44.
  23. Higgins M, Mc Auliffe F. A review of maternal and fetal growth factors in diabetic pregnancy. Curr Diabetes Rev 2010 Mar;6(2):116-25.