Indices of Glucose Homeostasis in Cord Blood in Term and Preterm Newborns

Metabolic flexibility during late pregnancy is associated with neonatal adiposity

The aim of this study was to determine the relationships between maternal metabolic flexibility during pregnancy and neonatal health outcomes. Percent change in lipid oxidation (before and after a high-fat meal) was calculated as the measure of "metabolic flexibility". Neonatal adiposity was assessed within 48 h of delivery by skinfold anthropometry. Metabolic flexibility (r = -0.271, p = 0.034), maternal HOMA-IR (r = 0.280, p = 0.030), and maternal body mass index (r = 0.299, p = 0.018) were correlated with neonatal subscapular skinfold (i.e., measure of neonatal adiposity). Clinical Trail Registration Number: NCT03504319. Novelty: This is the first study to link maternal metabolic flexibility, body mass index, and insulin resistance during pregnancy to neonatal adiposity at parturition.

Assessment of insulin resistance in preterm children appropriate for gestational age versus term and preterm children with intrauterine growth restriction

INTRODUCTION

Estimation of carbohydrate metabolism parameters in the groups: AGA preterm, SGA term, SGA preterm and AGA term.

MATERIAL AND METHODS

89 children were qualified: group A - AGA preterm 22, group B - SGA preterm 26, SGA term group C - 30 children, AGA - term group D - 11 children; at the age of 6-7 years. Insulin and fasting glucose levels were measure. HOMA IR and QUICKI, lipid profile were calculated.

RESULTS

Higher insulin concentration were found in groups C vs. A (6.93 vs. 3.68 uIU/ml, p = 0.00005); B vs A (5.49 vs. 3.68 uIU/ml, p = 0.02). HOMA IR was significantly higher in the C vs A group (1.38 vs. 0.73, p = 0.00014); and B vs A (1.11 vs. 0.73, p = 0.03). Quicki were lower in C vs. A (0.7 vs. 0.96, p = 0.00068).

CONCLUSIONS

The risk of insulin resistance appears to be more associated with lower birth weight than time of birth. No greater risk of insulin resistance has been established in preterm births with AGA.

Characterizing the Effects of Diabetes and Obesity on Insulin and Leptin Levels amongst Pregnant Women

OBJECTIVE

In this study, we assess the impact of obesity and diabetes on maternal brain and periphery, as well as fetal exposure to insulin and leptin, and two hormones that play an important role in regulating energy homeostasis.

STUDY DESIGN

Fasting maternal plasma, fetal cord vein and artery plasma, and maternal cerebrospinal fluid (CSF) were collected in 37 women (12 lean, nondiabetic [prepregnancy body mass index (BMI): 22.9 ± 1.7 kg/m²]; 12 overweight/obese nondiabetic [BMI: 37.8 ± 7.3 kg/m²]; 13 gestational/type 2 diabetes mellitus [BMI: 29.8 ± 7.3 kg/m²]) with uncomplicated singleton pregnancies undergoing elective Cesarean delivery. HbA1C, insulin, glucose, and leptin levels were measured.

RESULTS

Compared with lean mothers, mothers with obesity and diabetes mellitus (DM) had significantly lower CSF-to-plasma ratios of insulin. Moreover, mothers with obesity and DM had significantly lower cord arterial and cord venous to maternal plasma ratios of insulin, but not leptin, compared with lean mothers. There were no differences in CSF and cord blood insulin and leptin levels between obese and DM mothers.

CONCLUSION

Compared with lean individuals, mothers with obesity and DM have relative deficiencies in insulin exposure. The patterns observed in mothers with obesity and diabetes were similar highlighting the importance of the maternal metabolic environment in obesity and suggesting obese patients warrant further clinical focus.

Differences in omentin-1 levels in term newborns according to birth weight

BACKGROUND

Adipokines are produced by adipose tissue and are involved in metabolic processes. Omentin-1 is an adipokine that has been shown in vitro to possibly be involved in insulin sensitivity modulation. The prenatal stage is a crucial period for development of metabolic diseases in the long term, therefore, small (SGA) and large (LGA) for gestational age newborns have an increased risk of type 2 diabetes and metabolic syndrome later in life.

AIMS

To evaluate the differences in omentin-1 concentrations in umbilical cord blood from healthy term newborns according to birth weight and explore the association between omentin-1 and anthropometry, glucose, insulin and insulin sensitivity.

STUDY DESIGN

This was a secondary analysis of stored umbilical cord blood of term newborns.

SUBJECTS

Newborns classified according to birth weight as SGA (n = 30), adequate for gestational age (AGA) (n = 12) and LGA (n = 34).

OUTCOME MEASURES

An analysis of omentin-1, glucose and insulin were performed.

RESULTS

Differences were found in serum omentin-1 levels (ng/mL) between SGA 328.17 ± 108.04, AGA 253.05 ± 98.25 and LGA 250.91 ± 100.48 (p = 0.009). In the linear regression analysis, the independent variables HOMA-IR, QUICK-I and FGIR were predictors of serum omentin-1 levels (r = 0.175, p = 0.003).

CONCLUSIONS

Omentin-1 cord blood levels have a differentiated behavior according to weight for gestational age with LGA newborns having lower levels and SGA newborns higher levels. HOMA-IR, QUICK-I and FGIR weakly predicted omentin-1 in cord blood, suggesting that omentin-1 possibly has an implication in insulin sensitivity since birth.

Risk of hypertension following perinatal adversity: IUGR and prematurity

Consistent with the paradigm shifting observations of David Barker and colleagues that revealed a powerful relationship between decreased weight through 2 years of age and adult disease, intrauterine growth restriction (IUGR) and preterm birth are independent risk factors for the development of subsequent hypertension. Animal models have been indispensable in defining the mechanisms responsible for these associations and the potential targets for therapeutic intervention. Among the modifiable risk factors, micronutrient deficiency, physical immobility, exaggerated stress hormone exposure and deficient trophic hormone production are leading candidates for targeted therapies. With the strong inverse relationship seen between gestational age at delivery and the risk of hypertension in adulthood trumping all other major cardiovascular risk factors, improvements in neonatal care are required. Unfortunately, therapeutic breakthroughs have not kept pace with rapidly improving perinatal survival, and groundbreaking bench-to-bedside studies are urgently needed to mitigate and ultimately prevent the tsunami of prematurity-related adult cardiovascular disease that may be on the horizon. This review highlights our current understanding of the developmental origins of hypertension and draws attention to the importance of increasing the availability of lactation consultants, nutritionists, pharmacists and physical therapists as critical allies in the battle that IUGR or premature infants are waging not just for survival but also for their future cardiometabolic health.

Hepatitis B X-interacting protein promotes the formation of the insulin gene-transcribing protein complex Pdx-1/Neurod1 in animal pancreatic β-cells

The activation of insulin gene transcription depends on multiple nuclear proteins, including the transcription factors PDX-1 and NEUROD1, which form a transcriptional complex. We recently reported that hepatitis B X-interacting protein (HBXIP, also termed LAMTOR5) can modulate glucose metabolism reprogramming in cancer cells. However, the physiological role of HBXIP in the modulation of glucose metabolism in normal tissues is poorly understood. Here, we report that Hbxip is an essential regulator of the effect of the Pdx-1/Neurod1 complex on insulin gene transcription in murine pancreatic β-cells in vitro and in vivo We found that pancreatic β-cell-specific Hbxip-knockout mice displayed higher fasting blood glucose levels and impaired glucose tolerance. Furthermore, Hbxip was involved in the regulation of insulin in the pancreas islets and increased insulin gene expression in rat pancreatic β-cells. Mechanistically, Hbxip stimulated insulin enhancer activity by interacting with Pdx-1 and recruiting Neurod1 to Pdx-1. Functionally, we provide evidence that Hbxip is required for Pdx-1/Neurod1-mediated insulin expression in rat pancreatic β-cells. Collectively, these results indicate that Hbxip is involved in the transcription of insulin by increasing the levels of the Pdx-1/Neurod1 complex in animal pancreatic β-cells. Our finding provides the insight into the mechanism by which Hbxip stimulates the transcription of the insulin gene.