2nd Department of Internal Medicine, Semmelweis University, Budapest, Hungary.
Eur J Clin Invest. 2015 Feb;45(2):196-203. doi: 10.1111/eci.12397.
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.
This study has been conducted in two Hungarian and one Austrian centres.
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.
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).
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.
已在患有糖尿病的成年人中描述了组织特异性二肽基肽酶 4（DPP4）失调。DPP4-肠降血糖素系统在胎儿期尚未得到研究。在这项研究中，评估了患有妊娠糖尿病（GDM）和非糖尿病对照孕妇脐带血中的 DPP4 活性和胰高血糖素样肽 1（GLP-1）水平。
本研究在匈牙利的两个中心和奥地利的一个中心进行。
共有 568 名孕妇在 24-28 孕周的 OGTT 后被纳入研究。在 270 例（DPP4：159 例对照，111 例 GDM）和 112 例（GLP-1：72 例对照，40 例 GDM）中进行了脐带血采样，以测量 DPP4 活性和 GLP-1 水平。在分娩时进行了 OGTT（24-28 孕周）和脐带血采样。连续监测微板基动力学测定法测定脐带血清 DPP4 活性，荧光 ELISA 法测定脐带血浆 GLP-1。
GDM 组脐带血清 DPP4 活性低于对照组[平均值（95%CI）：28.07 U/L（26.32-29.82 U/L）] [31.61 U/L（29.93-33.29 U/L），MWU P = 0.0015]。GDM 中活性 GLP-1 水平接近检测下限且未改变（对照：均值= 3.43 pM，95%CI：3.04-3.82 pM，GDM：均值= 3.61 pM，95%CI：2.96-4.28 pM-MWU 检验 P = 0.6）。
妊娠糖尿病中脐带血清 DPP4 活性降低可能是胎儿适应性反应的结果，或者是肠胰岛轴的早期失调，其后果超出了肠降血糖素系统。脐带血浆 GLP-1 水平可能反映了胎儿期通过循环进行的细胞摄入不足和 L 细胞的葡萄糖感应有限。
