Leptin and metabolic hormones in infants of diabetic mothers
P C Nga, C W K Lamb, C H Leea, G W K Wonga, T F Foka, E Wongc, K C Maa, I H S Chanb
a Department of
Paediatrics, Level 6, Clinical Science Building, Prince of Wales
Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong, b Department of Chemical Pathology,
Prince of Wales Hospital, c Centre for Clinical Trials and Epidemiological
Research, Prince of Wales Hospital
Correspondence to: Prof. Ng pakcheungng{at}cuhk.edu.hk
Accepted 16 June 2000
AIMS
To investigate the effect of
maternal diabetes on leptin in term newborns and to determine whether
leptin correlates with insulin and its associated biochemical
parameters in support of the hypothesis that a functional
"adipoinsular axis" might exist at this stage of development.
METHODSA total of 116 term
newborns were prospectively enrolled and categorised into three groups:
44 were infants of non-diabetic mothers (control group C); 41 were
infants born to mothers with gestational diabetes on dietary treatment
(group D); and 31 were infants born to mothers with gestational or
pregestational diabetes on insulin treatment (group I).
RESULTSNo significant difference
in serum leptin was observed between the three groups; the results of
the study population were therefore pooled and analysed. Serum leptin
correlated significantly with serum insulin, insulin:glucose ratio,
birth weight, body length, body mass index, placenta weight, and
maternal HbA1c. Female infants had significantly higher
serum leptin than male infants. All parameters except placenta weight
and body length remained significantly associated with serum leptin
when multivariate stepwise regression analysis was applied. Subgroup
analysis revealed a significant correlation between serum leptin and
cortisol in group D.
CONCLUSIONSThere was no
significant difference in serum leptin between infants born to diabetic
and non-diabetic mothers, though infants born to mothers requiring
insulin treatment had the highest median serum leptin concentrations.
The significant association between serum leptin and insulin or
insulin:glucose ratio supports the hypothesis that a functional
adipoinsular axis might exist in term newborns. Furthermore, the
significant correlation between maternal HbA1c and
circulating leptin of the studied infants suggests that the clinical
control of maternal diabetes could affect the regulation of serum
leptin in these infants.
|
Key message
An active "adipoinsular axis" is likely to exist in term newborns. The clinical control of maternal diabetes may affect the regulation of serum leptin and possibly may also influence the growth of the fetus in utero |
Keywords: leptin; insulin; diabetes; adipoinsular axis
© 2000 by Archives of Disease in Childhood
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