74 Gestational Diabetes: Cord Blood Insulin, IGF-I and IGF-II Levels in Relation to Anthropometric Parameters of Neonates Born as Aga or LGA

Abstract

Insulin, IGF-1 and IGF-2 are considered as the main growth factors during fetal life. The aim of the study was to evaluate the relationship between cord blood insulin, IGF-I and IGF-II concentrations and antrophometric parameters in neonates of GDM mothers born with different birth weight categories: appropriate (AGA) or large (LGA) for gestational age.Material and methods: The study covered 72 newborns born to GDM mothers divided into 2 groups - 35 LGA and 37 AGA. 40% mothers from LGA and 48,6% from AGA group were on diet only and the others on insulin. There was no significant difference in the mean GA between the groups (AGA -38,2 ± 2,2; LGA - 38,4 ± 1,8 weeks). Anthropometric measurement (body mass, length, head and chest circumference) was done at birth. Umbilical venous blood was taken after delivery and concentration of insulin (RIA), IGF-I (Immunoassay Quantikine) and IGF-II (ELISA Biosource) was estimated.Results: Insulin and IGF-I levels were significantly lower in AGA than in LGA group (4,5 v. 6,8 μIU/ml and 64,9 v. 79,0 ng/ml). A significant positive correlation between IGF-I and insulin levels in LGA group was noticed (r=0,33; p<0,05). IGF-II and insulin levels correlates positively with body mass (r=0,31; p<0,05; and r= 0,57; p<0,001) as well as head circumference (r=0,37; p<0,05 and r=0,44; p<0,01) in LGA but not AGA group. In LGA group a positive correlation between insulin (r=0,39; p<0,01) as well as IGF-I (r=0,31;p<0,05) levels and chest circumference was found.Conclusion: There is an association between normal birth weight and occurring of low cord blood insulin and IGF-I levels in neonates of the GDM mothers. Moreover unfavourable influence of insulin and IGF-I on body mass and proportion between head and chest circumference in LGA neonates born to GDM mothers may be balanced by beneficial IGF-II influence on head circumference.