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IGF-I and IGF-binding protein-1 are related to cortisol in human cord blood
S Cianfarani1, D Germani, L Rossi
1Laboratory of Pediatric Endocrinology, Tor Vergata University, Rome, Italy.
Insights
High cortisol in cord blood may predict growth in infants with intrauterine growth retardation (IUGR). This suggests cortisol regulates fetal growth and may indicate postnatal catch-up growth potential in IUGR infants.
Area of Science:
- Endocrinology
- Neonatal Physiology
- Fetal Development
Background:
- Intrauterine growth retardation (IUGR) is associated with altered fetal development and hormonal regulation.
- The insulin-like growth factor (IGF) system plays a crucial role in fetal and postnatal growth.
- Cortisol's role in modulating fetal growth, particularly in the context of IUGR, requires further elucidation.
Purpose of the Study:
- To evaluate cortisol concentrations in umbilical cord blood.
- To examine the relationship between cord blood cortisol and the IGF system (IGF-I, IGFBP-1, IGFBP-3).
- To investigate the association between cord blood cortisol and postnatal growth in infants with IUGR.
Main Methods:
- A comparative study involving newborns appropriate for gestational age (AGA) and infants with IUGR.
- Measurement of serum cortisol, IGF-I, IGFBP-1, and IGFBP-3 from umbilical cord blood.
- Longitudinal follow-up of IUGR infants for 3 months to assess growth parameters (weight, length).
Main Results:
- IUGR newborns exhibited significantly higher IGFBP-1 and lower IGF-I and IGFBP-3 concentrations compared to AGA controls.
- In AGA infants, cortisol showed inverse correlation with IGF-I and direct correlation with IGFBP-1.
- In IUGR infants, cord blood cortisol inversely correlated with length gain during the first trimester of life.
Conclusions:
- Cortisol may act as a physiological regulator of fetal growth, influencing IGF-I and IGFBP-1 release, especially under fetal stress.
- A potential rearrangement of the cortisol-IGF growth control mechanism appears in IUGR infants.
- Cord blood cortisol levels may serve as a predictive marker for early postnatal catch-up growth in IUGR infants.
Objective:
To assess cortisol concentrations in cord blood and investigate their relationships with the IGF system.
Study Design:
Fifteen newborns with birth weight appropriate for gestational age (AGA) and 30 children with intrauterine growth retardation (IUGR) were studied. Serum samples were collected from umbilical cord blood and cortisol, IGF-I and IGF-binding proteins (IGFBPs)-1 and -3 were measured. IUGR infants were followed up for 3 months with repeated measurements of weight, supine length and knee-heel length (by knemometry).
Results:
IUGR newborns showed significantly greater concentrations of IGFBP-1 (P<0.0001) and lower concentrations of IGF-I (P< 0.0001) and IGFBP-3 (P< 0.0001) than did controls. In AGA children, cortisol correlated inversely with IGF-I (r=-0.75, P< 0.002) and directly with IGFBP-1 (r=0.52, P <0.05), whereas no correlation between cortisol and IGF system-related variables was observed in IUGR. Finally, in IUGR children an inverse correlation was found between length gain in the first trimester of life and cortisol concentrations at birth (r=-0.54, P < 0.005).
Conclusions:
Cortisol might be a physiological regulator of fetal growth, at least in the last part of pregnancy, by modulating IGF-I and IGFBP-1 release under conditions of fetal stress. In IUGR children, a rearrangement of this growth control mechanism seems to occur. The close inverse relationship of cortisol with linear growth, if confirmed by large-scale studies, suggests cord blood cortisol to be potentially predictive of early postnatal catch-up growth in IUGR infants.