Azuma Dara, Penner Yvette, Kaneko-Tarui Tomoko, Mahmoud Taysir, Breeze Janis L, Rodday Angie, O'Tierney-Ginn Perrie, Maron Jill L
Mother Infant Research Institute at Tufts Medical Center, Boston, MA, United States.
Frances Stern Nutrition Center at Tufts Medical Center, Boston, MA, United States.
Front Clin Diabetes Healthc. 2024 Dec 19;5:1501805. doi: 10.3389/fcdhc.2024.1501805. eCollection 2024.
Infants of diabetic mothers (IDMs) may exhibit decreased oral intake, requiring nasogastric feedings and prolonged hospitalization. The objective of this study was to explore whether saliva serves as an informative biofluid for detecting expression of hunger signaling and energy homeostasis modulator genes and to perform exploratory analyses examining expression profiles, body composition, and feeding outcomes in late preterm and term IDMs and infants born to mothers with normoglycemia during pregnancy.
In this prospective cohort pilot study, infants born at ≥ 35 weeks' gestation to mothers with gestational or type II diabetes (IDM cohort) and normoglycemic mothers (control cohort) were recruited. The presence of known hunger signaling genes: 5'AMP-activated protein kinase () and neuropeptide Y2 receptor (); adipokines: leptin ) and adiponectin ; and energy homeostasis regulators: ghrelin and proopiomelanocortin in neonatal saliva was determined with RT-qPCR and compared between cohorts. Body composition was assessed via skinfold measurements and compared between cohorts. Feeding outcomes were recorded. Exploratory analyses were performed examining associations between infant body composition, energy homeostasis and hunger signaling gene expression.
Twenty-three infants in the IDM cohort and 22 infants in the control cohort were recruited. and were not reliably detected in neonatal saliva in either cohort. and were less likely to be detected in the IDM cohort, whereas was more likely to be detected in the IDM cohort. Infants in the IDM cohort had greater adiposity compared to infants in the normoglycemia cohort. Only 3 IDMs had documented poor feeding; no infant in the control group struggled to feed. In exploring associations between hunger signaling gene expression with energy homeostasis gene expression and body composition, the odds of detecting salivary expression decreased as fat mass increased, and the odds of detecting expression increased in the presence of expression.
Non-invasive assessment of hunger signaling and energy homeostasis gene expression is possible through neonatal salivary analysis. This pilot study lays the foundation for a larger scale study to further investigate the link between exposure to diabetes with body composition and regulation of appetite.
患有糖尿病母亲的婴儿（IDM）可能出现经口摄入量减少，需要鼻饲喂养并延长住院时间。本研究的目的是探讨唾液是否可作为一种有用的生物流体来检测饥饿信号和能量稳态调节基因的表达，并进行探索性分析，以检查晚期早产儿和足月儿IDM以及孕期血糖正常母亲所生婴儿的基因表达谱、身体组成和喂养结果。
在这项前瞻性队列试点研究中，招募了妊娠≥35周、母亲患有妊娠期糖尿病或II型糖尿病的婴儿（IDM队列）以及血糖正常母亲所生的婴儿（对照组）。用逆转录定量聚合酶链反应（RT-qPCR）测定新生儿唾液中已知饥饿信号基因：5'AMP激活蛋白激酶（）和神经肽Y2受体（）；脂肪因子：瘦素（）和脂联素（）；以及能量稳态调节因子：胃饥饿素（）和阿黑皮素原（）的存在情况，并在队列之间进行比较。通过皮褶测量评估身体组成，并在队列之间进行比较。记录喂养结果。进行探索性分析，以检查婴儿身体组成、能量稳态和饥饿信号基因表达之间的关联。
IDM队列招募了23名婴儿，对照组招募了22名婴儿。在两个队列的新生儿唾液中均未可靠检测到和。在IDM队列中检测到和的可能性较小，而在IDM队列中检测到的可能性较大。与血糖正常队列的婴儿相比，IDM队列的婴儿肥胖程度更高。只有3名IDM记录有喂养困难；对照组中没有婴儿喂养困难。在探索饥饿信号基因表达与能量稳态基因表达和身体组成之间的关联时，随着脂肪量增加，检测到唾液表达的几率降低，并且在存在表达的情况下，检测到表达的几率增加。
通过新生儿唾液分析可以对饥饿信号和能量稳态基因表达进行非侵入性评估。这项试点研究为进一步研究糖尿病暴露与身体组成和食欲调节之间联系的大规模研究奠定了基础。
