Cord serum dipeptidyl-peptidase 4 activity in gestational diabetes.

Abstract

BACKGROUND:

Tissue-specific dipeptidyl-peptidase 4 (DPP4) dysregulation has been described in adults with diabetes mellitus. The DPP4 -incretin system has not been studied in foetal life. In this study, DPP4 activity and glucagon-like peptide-1 (GLP-1) levels were assessed in cord blood of neonates born to women with gestational diabetes mellitus (GDM) and nondiabetic controls.

MATERIAL AND METHODS:

This study has been conducted in two Hungarian and one Austrian centres.

PATIENTS:

A total of 568 pregnant women were enrolled in the study after their OGTT between the 24th and 28th gestational week. Cord blood samplings with DPP4 activity and GLP-1 level measurements were possible in 270 (DPP4: 159 control, 111 GDM) and 112 (GLP-1: 72 control, 40 GDM) cases. OGTT (24-28th gestational week) and cord blood sampling at delivery were performed. Cord serum DPP4 activity was determined in a continuous monitoring microplate-based kinetic assay, and cord plasma GLP-1 was measured using a fluorescence ELISA method.

RESULTS:

Cord serum DPP4 activity was lower in GDM [mean (95% CI): 28.07 U/L (26.32-29.82 U/L)] than in controls [31.61 U/L (29.93-33.29 U/L), MWU P = 0.0015]. Cord plasma active GLP-1 levels were close to the lower detection limit and were not altered in GDM (control: mean = 3.43 pM, 95% CI: 3.04-3.82 pM, GDM: mean = 3.61 pM, 95% CI: 2.96-4.28 pM - MWU test P = 0.6).

CONCLUSIONS:

Decreased cord serum DPP4 activity in gestational diabetes mellitus might be the result of an adaptive foetal response or an early dysregulation in the entero-insular axis with consequences beyond the incretin system. Cord plasma GLP-1 levels may reflect the missing oral intake with a limited glucose sensing of L cells via the circulation in foetal life.

• Authors: Zahra Al-Aissa, Klára Rosta, Orsolya Hadarits, Jürgen Harreiter, András Zóka, Dagmar Bancher-Todesca, Attila Patócs, Katalin Kiss, Beatrix Sármán, Péter Pusztai, István Sziller, János Rigó, Károly Rácz, Anikó Somogyi, Alexandra Kautzky-Willer, Gábor Firneisz
• Journal: European journal of clinical investigation (Eur J Clin Invest) Vol. 45 Issue 2 Pg. 196-203 (Feb 2015) ISSN: 1365-2362 [Electronic] England
• PMID: 25556541 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: © 2014 Stichting European Society for Clinical Investigation Journal Foundation.

Chemical References

• Blood Glucose
• Hypoglycemic Agents
• Insulins
• Glucagon-Like Peptide 1
• Dipeptidyl Peptidase 4

Topics

• Adult
• Blood Glucose (metabolism)
• Case-Control Studies
• Diabetes, Gestational (diet therapy, drug therapy, enzymology)
• Dipeptidyl Peptidase 4 (metabolism)
• Female
• Fetal Blood (metabolism)
• Glucagon-Like Peptide 1 (metabolism)
• Humans
• Hypoglycemic Agents (therapeutic use)
• Insulins (therapeutic use)
• Pregnancy
• Pregnancy Outcome