The association of ghrelin, leptin, and insulin levels in umbilical cord blood with fetal anthropometric measurements and glucose levels at birth.

Objectives: To investigate the association of ghrelin, leptin, and insulin levels in the umbilical cord blood of the preterm and term infants with anthropometric measurements and glucose metabolism.Methods: Sixty-nine infants who were born between November 2004 and June 2005 were included in the study. Pregnancy ages, birth weights, heights, head circumferences, and Ponderal Indexes (PI) were identified. Ghrelin, leptin, insulin, and glucose levels in the umbilical cord blood were studied.Results: Eighteen infants out of 69 infants were preterm (34.6 ± 0.43 weeks), and 33 infants were term (38.7 ± 0.14 weeks). All preterm infant weights were appropriate for gestational age (AGA); 33 of the term infants' weights were AGA and 18 were large for gestational age (LGA). Leptin, insulin, and glucose levels of term infants were significantly higher compared with the preterm infants (p < .0001, p < .001, and p < .0001, respectively); no significant difference was detected in the ghrelin levels between the two groups (p > .05). The leptin and insulin levels of the term LGA infants were higher compared with the term AGA and preterm AGA infants (p < .05, for all). No difference was detected between the three groups regarding serum ghrelin levels (p > .05). No difference was found in the glucose levels between term AGA and LGA infants (p > .05); however, the serum glucose levels of term AGA and LGA infants were higher compared with levels in preterm AGA infants (p < .05, for both). A positive correlation was demonstrated in all study groups between leptin and insulin with gestational age, body weight, height, head circumference, and PI. A positive correlation was found between serum leptin levels with gestational age and insulin levels in preterm infants, and between serum leptin levels and insulin and glucose levels in term infants. No association was found between ghrelin and anthropometric measurements, leptin, insulin, and glucose levels (p > .05, for all).Conclusions: The increase of leptin production with increased gestational age, and the strong association with anthropometric measurements supports the opinion that leptin behaves as a fetal growth factor. Leptin in intrauterine life is in close association with insulin and glucose metabolism. Although ghrelin was at measurable levels in preterms, no association with fetal growth and glucose metabolism could be demonstrated in preterm and term infants.

The Role of Umbilical Cord Blood Concentration of IGF-I, IGF-II, Leptin, Adiponectin, Ghrelin, Resistin, and Visfatin in Fetal Growth.

OBJECTIVE: Herein, we measured the concentration of insulinlike growth factor I (IGF-I), IGF-II, leptin, adiponectin, ghrelin, resistin, and visfatin in the umbilical cord blood of newborns categorized as "small for gestational age" (SGA), "appropriate for gestational age" (AGA), and "large for gestational age" (LGA). Our aim was to elucidate the link between the levels of these proteins and fetal growth. STUDY DESIGN: A total of 96 term infants were included and categorized into three weight categories. Their venous cord blood samples were collected to measure the levels of IGF-I, IGF-II, leptin, adiponectin, ghrelin, resistin, and visfatin. RESULTS: IGF-I, visfatin, and leptin levels showed significant differences among the groups. Pairwise comparisons showed that adiponectin (p = 0.023), resistin (p = 0.025), and ghrelin (p = 0.005) levels were significantly lower in the SGA group than in the LGA group. Correlation analyses showed a strong association of IGF-1, IGF-II, and leptin levels with birth weight (r = 0.644, p < 0.001; r = 0.441, p < 0.001; and r = 0.404, p < 0.001, respectively). CONCLUSION: SGA newborns showed a significantly higher visfatin concentration and lower ghrelin, leptin, resistin, and adiponectin levels than the AGA and LGA newborns did.

Plasma and urinary endothelin-1 concentrations in asphyxiated newborns [corrected].

The aim of this study was to determine if there is any correlation between the hypoxia induced deterioration of renal functions and urinary excretions of endothelin (ET). Therefore using a sensitive and specific radioimmunoassay, we have investigated plasma ET-1 concentrations and urine ET-1 excretions in healthy and asphyxiated newborns. Sixteen newborns (10 boys, 6 girls) with perinatal asphyxia or hypoxia of variable seriousness which were followed at Newborn Intensive Care Unit in Eskisehir Osmangazi University Faculty of Medicine were enrolled. Simultaneously, gestation and weight matched 10 newborns (6 boys, 4 girls) with no asphyxia (first minute Apgar score >7) were enrolled as controls. Plasma ET-1 concentrations of the asphyxiated infants (61.8+/-79.3 pg/ml, between 23.4-125.2 pg/ml) were higher than in the control group (29.3+/-22.1 pg/ml, between 12.3 and 50.8 pg/ml, p<0.05). However creatinine clearance values were not different between the two groups (p>0.05), mean fractional excretion of sodium levels (FeNa%) were higher in the study group than the controls (p<0.01). Urinary ET-1 concentrations in the asphyxiated infants were 144.6+/-63.4 pg/ml versus 70.1+/-27.7 pg/ml in the control group (p<0.001). The ET clearance were more elevated in the asphyxiated newborns than in the healthy infants (p<0.05). Urinary ET-1/Cr ratio in the hypoxic infants were significantly elevated in the first day of life when compared with those of healthy infants (p<0.05). Total ET excretion was negatively correlated with FeNa (%) (r=-0.603, p<0.05). Plasma ET-1 concentrations of the asphyxiated infants reduced at 48 hours of age (p<0.001). Fifth minute Apgar score was negatively correlated with urinary ET-1 levels (r=-0.615, p<0.01), urinary Na excretion (r=-0.583, p<0.01), FeNa (%) (r=-0.597, p<0.01) and total ET excretion (r=-0.560, p<0.01) and positively correlated with ET clearance (r=0.559, p<0.05). Urinary ET-1 levels were negatively correlated with umbilical artery BE levels (r=-0.612, p<0.05). To our study, elevated urinary ET-1 levels were observed during perinatal asphyxia and urinary ET-1 levels were negatively correlated with 5th minute Apgar score and cord blood base excess levels. For this reason urinary ET-1 levels could be a marker of perinatal asphyxia as cord blood ET-1 levels. With investigations showing renal production is independent from plasma and increased urinary ET-1/Cr levels in newborn with perinatal asphyxia and also negative correlation between the total ET excretion and FeNa, urinary ET-1 levels could be served as a useful marker to detecting also impaired renal functions in infants with perinatal asphyxia.