부산대학교 도서관

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. [ABSTRACT FROM AUTHOR]