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Cord serum dipeptidyl-peptidase 4 activity in gestational diabetes

Zahra Al-Aissa1, Klára Rosta, Orsolya Hadarits

  • 12nd Department of Internal Medicine, Semmelweis University, Budapest, Hungary.

European Journal of Clinical Investigation
|January 6, 2015
PubMed

Insights

Gestational diabetes mellitus (GDM) in mothers is linked to lower cord blood DPP4 activity in newborns. This suggests an early fetal adaptation or dysregulation, as cord blood GLP-1 levels remain unchanged.

Area of Science:

  • Endocrinology
  • Metabolic disorders
  • Perinatal medicine

Background:

  • Dipeptidyl-peptidase 4 (DPP4) dysregulation is known in adult diabetes.
  • The DPP4-incretin system's role in fetal life is largely unstudied.
  • Gestational diabetes mellitus (GDM) presents a unique context for fetal metabolic studies.

Purpose of the Study:

  • To investigate DPP4 activity and glucagon-like peptide-1 (GLP-1) levels in cord blood of neonates from mothers with GDM.
  • To compare these markers between GDM and non-diabetic pregnancies.
  • To explore potential fetal adaptations or early dysregulations in the entero-insular axis.

Main Methods:

  • Cord blood samples were collected from neonates of 568 pregnant women (24-28 weeks gestation) undergoing OGTT.
  • DPP4 activity was measured using a kinetic assay, and active GLP-1 levels via ELISA.
  • Data analyzed from 270 samples for DPP4 and 112 for GLP-1, comparing GDM and control groups.

Main Results:

  • Neonates from mothers with GDM exhibited significantly lower cord serum DPP4 activity compared to controls (P = 0.0015).
  • Cord plasma active GLP-1 levels were near the detection limit and showed no significant difference between GDM and control groups (P = 0.6).

Conclusions:

  • Reduced cord serum DPP4 activity in GDM may indicate an adaptive fetal response or early entero-insular axis dysregulation.
  • Stable cord plasma GLP-1 levels might reflect limited fetal oral intake and glucose sensing via L-cells.
  • Findings suggest implications for fetal metabolic programming beyond the incretin system.
Abstract

Keywords:
Cord blooddipeptidyl-peptidase 4 (DPP4)gestational diabetes mellitus (GDM)glucagon-like peptide-1 (GLP-1)pregnancy

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