Z Geburtshilfe Neonatol 2019; 223(01): 48-53
DOI: 10.1055/a-0660-9734
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

Levels of Glucagon-like Peptide 1 are Decreased in Macrosomic Neonates from Non-Diabetic Mothers

Ayla Aktulay
1   Obstetrics and gynecology, University of Health Sciences, Zekai Tahir Burak Health Practice Research Center, Ankara, Turkey
,
Yaprak Engin-Ustun
1   Obstetrics and gynecology, University of Health Sciences, Zekai Tahir Burak Health Practice Research Center, Ankara, Turkey
,
Ozlem Gunduz Yasar
1   Obstetrics and gynecology, University of Health Sciences, Zekai Tahir Burak Health Practice Research Center, Ankara, Turkey
,
Canan Yilmaz
2   Biochemistry, Gazi University, School of Medicine, Ankara, Turkey
,
Salim Erkaya
1   Obstetrics and gynecology, University of Health Sciences, Zekai Tahir Burak Health Practice Research Center, Ankara, Turkey
,
A. Seval Ozgu-Erdinc
3   Perinatology, University of Health Sciences, Zekai Tahir Burak Health Practice Research Center, Ankara, Turkey
› Author Affiliations
Further Information

Publication History

received 03 April 2018

accepted 17 July 2018

Publication Date:
24 August 2018 (online)

Abstract

Glucagon-like peptide 1 (GLP-1) is a gut-derived peptide with insulin-like effects. Our aim was to analyze cord blood GLP-1 levels of macrosomic and appropriate-gestational-age (AGA) neonates from non-diabetic mothers. A case-control study was conducted with 22 term macrosomic neonates (birth weight≥4000 g) and 22 AGA (birth weight>10th percentile and<4000 g) pregnancies. Cord blood GLP-1 levels of neonates were measured. There were no significant differences in maternal age, gestational age and gravida between the 2 groups. Umbilical cord blood GLP-1 levels were significantly lower in macrosomic neonates (6.9±2.9 pg/mL) compared with control group (10.3±3.7 pg/mL) (p=0.002). Binary logistic regression analysis showed only the maternal BMI to be an independent statistically significant predictor of macrosomia (odds ratio=2.459; 95% CI, 1.170–5.170; P=0.018). The results of our study revealed decreased GLP-1 levels in macrosomic neonates, and maternal BMI was an independent predictor of macrosomia.

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  • References

  • 1 Araujo Júnior E, Peixoto AB, Zamarian ACP. et al. Macrosomia. Best Pract Res Clin Obstet Gynaecol 2016; DOI: 10.1016/j.bpobgyn.2016.08.003.
  • 2 American College of Obstetricians and Gynecologistsʼ Committee on Practice Bulletins–Obstetrics. Practice Bulletin No. 173: Fetal Macrosomia. Obstet Gynecol 2016; 128: e195-e209
  • 3 Ventura SJ, Martin JA, Curtin SC. et al. Births: final data for 1998. Natl Vital Stat Rep 2000; 48: 1-100
  • 4 Haram K, Pirhonen J, Bergsjo P. Suspected big baby: a difficult clinical problem in obstetrics. Acta Obstet Gynecol Scand 2002; 81: 185-194
  • 5 Ahmed SR, Ellah MA, Mohamed OA. et al. Prepregnancy obesity and pregnancy outcome. Int J Health Sci (Qassim) 2009; 3: 203-208
  • 6 Aka N, Etiz Sayharman S. Yaşlak et al. Evaluation of perinatal and maternal complications type of deliveries and neonatal outcomes in macrosomic and normal weighed newborns in our clinic between 2000 and 2010 years. Gynecol Obstet Reprod Med 2011; 17: 16-19
  • 7 Hermann GM, Dallas LM, Haskell SE. et al. Neonatal macrosomia is an independent risk factor for adult metabolic syndrome. Neonatology 2010; 98: 238-244
  • 8 Kerenyi Z, Tamas G, Kivimaki M. et al. Maternal glycemia and risk of large-for-gestational-age babies in a population-based screening. Diabetes Care 2009; 32: 2200-2205
  • 9 İnegöl Gümüş İ, Kamalak Z, Aktepe Keskin E. et al. Maternal-fetal risk increase from 41 weeks of gestation. Gynecol Obstet Reprod Med 2007; 13: 147-149
  • 10 Şengül Ö, Mungan T, Erdemoğlu E. et al. Cord blood leptin levels in gestational diabetes. Gynecol Obstet Reprod Med 2010; 16: 70-74
  • 11 Surkan PJ, Hsieh CC, Johansson AL. et al. Reasons for increasing trends in large for gestational age births. Obstet Gynecol 2004; 104: 720-726
  • 12 Bergmann RL, Richter R, Bergmann KE. et al. Secular trends in neonatal macrosomia in Berlin: influences of potential determinants. Paediatr Perinat Epidemiol 2003; 17: 244-249
  • 13 Westerway SC, Keogh J, Heard R. et al. Incidence of fetal macrosomia and birth complications in Chinese immigrant women. Aust N Z J Obstet Gynaecol 2003; 43: 46-49
  • 14 Ekmektzoglou K, Demestiha T, Troupis G. et al. Commonest overgrowth syndromes. Fetal Pediatr Pathol 2012; 31: 94-111
  • 15 Okun N, Verma A, Mitchell BF. et al. Relative importance of maternal constitutional factors and glucose intolerance of pregnancy in the development of newborn macrosomia. J Matern Fetal Med 1997; 6: 285-290
  • 16 Ehrenberg HM, Mercer BM, Catalano PM. The influence of obesity and diabetes on the prevalence of macrosomia. Am J Obstet Gynecol 2004; 191: 964-968
  • 17 Schwartz N, Quant HS, Sammel MD. et al. Macrosomia has its roots in early placental development. Placenta 2014; 35: 684-690
  • 18 Mossayebi E, Arab Z, Rahmaniyan M. et al. Prediction of neonatesʼ macrosomia with maternal lipid profile of healthy mothers. Pediatr Neonatol 2014; 55: 28-34
  • 19 Sunsaneevithayakul P, Titapant V, Ruangvutilert P. et al. Relation between gestational weight gain and pregnancy outcomes. J Obstet Gynaecol Res 2014; 40: 995-1001
  • 20 Alberico S, Montico M, Barresi V. et al. The role of gestational diabetes, pre-pregnancy body mass index and gestational weight gain on the risk of newborn macrosomia: results from a prospective multicentre study. BMC Pregnancy Childbirth 2014; 14: 23
  • 21 Masuyama H, Mitsui T, Maki J. et al. Dimethylesculetin ameliorates maternal glucose intolerance and fetal overgrowth in high-fat diet-fed pregnant mice via constitutive androstane receptor. Mol Cell Biochem 2016; 419: 185-192
  • 22 Sayın NC, Varol FG, Duran R. et al. Perinatal outcome in women screened for gestational diabetes mellitus with normal or with one elevated glucose tolerance test value. J Turk Ger Gynecol Assoc 2007; 8: 38-43
  • 23 Holst JJ. The physiology of glucagon-like peptide 1. Physiol Rev 2007; 87: 1409-1439
  • 24 Orskov C, Jeppesen J, Madsbad S. et al. Proglucagon products in plasma of noninsulin-dependent diabetics and nondiabetic controls in the fasting state and after oral glucose and intravenous arginine. J Clin Invest 1991; 87: 415-423
  • 25 Hare KJ, Vilsboll T, Asmar M. et al. The glucagonostatic and insulinotropic effects of glucagon-like peptide 1 contribute equally to its glucose-lowering action. Diabetes 2010; 59: 1765-1770
  • 26 Holst JJ, Knop FK, Vilsboll T. et al. Loss of incretin effect is a specific, important, and early characteristic of type 2 diabetes. Diabetes Care 2011; 34 (Suppl. 02) S251-S257
  • 27 Vilsboll T. On the role of the incretin hormones GIP and GLP-1 in the pathogenesis of Type 2 diabetes mellitus. Dan Med Bull 2004; 51: 364-370
  • 28 Meier JJ, Nauck MA. Is secretion of glucagon-like peptide-1 reduced in type 2 diabetes mellitus?. Nat Clin Pract Endocrinol Metab 2008; 4: 606-607
  • 29 Nauck MA, Vardarli I, Deacon CF. et al. Secretion of glucagon-like peptide-1 (GLP-1) in type 2 diabetes: what is up, what is down?. Diabetologia 2011; 54: 10-18
  • 30 Papaioannou TG, Protogerou AD, Vrachatis D. et al. Mean arterial pressure values calculated using 7 different methods and their associations with target organ deterioration in a single-center study of 1878 individuals. Hypertens Res 2016; 39: 640-647
  • 31 Carpenter MW, Coustan DR. Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol 1982; 144: 768-773
  • 32 World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. Jama 2013; 310: 2191-2194
  • 33 Cypryk K, Vilsboll T, Nadel I. et al. Normal secretion of the incretin hormones glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 during gestational diabetes mellitus. Gynecol Endocrinol 2007; 23: 58-62
  • 34 Nauck M, Stockmann F, Ebert R. et al. Reduced incretin effect in type 2 (non-insulin-dependent) diabetes. Diabetologia 1986; 29: 46-52
  • 35 Ross SA, Dupre J. Effects of ingestion of triglyceride or galactose on secretion of gastric inhibitory polypeptide and on responses to intravenous glucose in normal and diabetic subjects. Diabetes 1978; 27: 327-333
  • 36 Tolhurst G, Reimann F, Gribble FM. Intestinal sensing of nutrients. Handb Exp Pharmacol 2012; DOI: 10.1007/978-3-642-24716-3_14.
  • 37 Lencioni C, Resi V, Romero F. et al. Glucagon-like peptide-1 secretion in women with gestational diabetes mellitus during and after pregnancy. J Endocrinol Invest 2011; 34: e287 290
  • 38 Yogev Y, Langer O. Pregnancy outcome in obese and morbidly obese gestational diabetic women. Eur J Obstet Gynecol Reprod Biol 2008; 137: 21-26
  • 39 Ryan EA. Diagnosing gestational diabetes. Diabetologia 2011; 54: 480-486
  • 40 HAPO Study Cooperative Research Group. Metzger BE, Lowe LP. et al Hyperglycemia and adverse pregnancy outcomes. N Engl J Med 2008; 358: 1991-2002
  • 41 Ricart W, Lopez J, Mozas J. et al. Body mass index has a greater impact on pregnancy outcomes than gestational hyperglycaemia. Diabetologia 2005; 48: 1736-1742
  • 42 Brook CG, Lloyd JK, Wolf OH. Relation between age of onset of obesity and size and number of adipose cells. Br Med J 1972; 2: 25-27
  • 43 Cao Y. Adipose tissue angiogenesis as a therapeutic target for obesity and metabolic diseases. Nat Rev Drug Discov 2010; 9: 107-115
  • 44 Catalano PM. Obesity, insulin resistance, and pregnancy outcome. Reproduction 2010; 140: 365-371
  • 45 Briana DD, Malamitsi-Puchner A. Reviews: adipocytokines in normal and complicated pregnancies. Reprod Sci 2009; 16: 921-937
  • 46 Hotamisligil GS, Murray DL, Choy LN. et al. Tumor necrosis factor alpha inhibits signaling from the insulin receptor. Proc Natl Acad Sci USA 1994; 91: 4854-4858
  • 47 Hotamisligil GS, Peraldi P, Budavari A. et al. IRS-1-mediated inhibition of insulin receptor tyrosine kinase activity in TNF-alpha- and obesity-induced insulin resistance. Science 1996; 271: 665-668
  • 48 Ategbo JM, Grissa O, Yessoufou A. et al. Modulation of adipokines and cytokines in gestational diabetes and macrosomia. J Clin Endocrinol Metab 2006; 91: 4137-4143
  • 49 Tomas E, Habener JF. Insulin-like actions of glucagon-like peptide-1: a dual receptor hypothesis. Trends Endocrinol Metab 2010; 21: 59-67
  • 50 Elahi D, Egan JM, Shannon RP. et al. GLP-1 (9-36) amide, cleavage product of GLP-1 (7-36) amide, is a glucoregulatory peptide. Obesity (Silver Spring) 2008; 16: 1501-1509
  • 51 Abu-Hamdah R, Rabiee A, Meneilly GS. et al. Clinical review: The extrapancreatic effects of glucagon-like peptide-1 and related peptides. J Clin Endocrinol Metab 2009; 94: 1843-1852
  • 52 Wajchenberg BL. Beta-cell failure in diabetes and preservation by clinical treatment. Endocr Rev 2007; 28: 187-218
  • 53 Ranganath LR, Beety JM, Morgan LM. et al. Attenuated GLP-1 secretion in obesity: cause or consequence?. Gut 1996; 38: 916-919