Evidence of increased intrauterine bone resorption in term infants of mothers with insulin-dependent diabetes☆,☆☆,★,★★
Section snippets
METHODS
Twenty-five term infants (gestational age, 38.8 ± 0.8 weeks; range, 38 to 41 weeks) born to women with insulin-dependent diabetes (class B-RT) from 1990 to 1993 were enrolled in the study. All women were entered prospectively during pregnancy and were followed in the diabetes clinic at the university hospital as part of a National Institutes of Health-sponsored diabetes-in-pregnancy program. The goals of glucose control were a fasting blood glucose value of less than 5.55 mmol/L (100 mg/dl) and
RESULTS
As expected, IDMs had a higher mean birth weight at term than normal infants (3854 ± 816 vs 3416 ± 378 gm; p = 0.005) and were more likely to be delivered by cesarean section (11/25 vs 0/20; p <0.0001). There was no difference in PICP serum concentrations between IDMs and control subjects: 1408 ± 489 versus 1407 ± 419 μg/L ( p = 0.99). Concentrations of ICTP were significantly higher in IDMs than in control subjects: 76.1 ± 17.3 versus 63.7 ± 13.5 μg/L ( p = 0.01). Both PICP and ICTP serum
DISCUSSION
Decreased BMC is a well-known complication of diabetes in children and adults, 5 and IDMs have been reported to have a decreased BMC in comparison with normal newborn infants, although the reason is not known. 1 We attempted to elucidate the mechanism for decreased BMC in IDMs by measuring cord blood concentrations of biochemical markers of bone formation and resorption. PICP is a marker of osteoblastic activity. Type I collagen represents approximately 90% of the organic matrix of bone,
References (9)
- et al.
Appearance of the intestinal cytosolic receptor for the 1,25-dihydroxyvitamin D 3 during neonatal development in the rat
J Biol Chem
(1981) - et al.
Decreased bone mineral content in infants of diabetic mothers
Am J Perinatol
(1988) - et al.
Characterization of the effect of insulin on collagen synthesis in fetal rat bone
Endocrinology
(1985) - et al.
Perinatal magnesium, calcium and 1,25(OH) 2 D in relation to prospective randomized management of maternal diabetes [Abstract]
Calcif Tissue Int
(1972)
Cited by (22)
Biomarkers of maternal diabetes and its complication in pregnancy
2012, Reproductive ToxicologyCitation Excerpt :The lower bone density could result from decreased bone formation or increased resorption or both. Indeed, Demarini et al. [33] have found that in cord blood of infants of diabetic mothers there was an increase in the markers of bone resorption with no difference in markers of bone formation. Harrast and Kalkwarf [32] measured markers of bone formation (carboxyterminal propeptide of collagen type 1) and of bone resorption (cross linked carboxyterminal of type 1 collagen) in 201 samples of amniotic fluid during weeks 14–40 of gestation.
Calcium Homeostasis in Human Placenta: Role of Calcium-Handling Proteins
2006, International Review of CytologyCitation Excerpt :Infants from diabetic mothers also occasionally present with hypocalcemia at birth. It seems that bone resorption is increased in a fetus from an insulin‐dependent diabetic mother (Demarini et al., 1995). The infant bone mass content is inversely correlated with poor control of maternal glycemia, specifically during the first trimester of pregnancy (Mimouni et al., 1988).
Biochemical Markers of Bone Metabolism
2003, Pediatric Bone: Biology & DiseasesBone in the pregnant mother and newborn at birth
2003, Clinica Chimica ActaBiochemical markers of maternal bone turnover are elevated in pre-eclampsia
2001, British Journal of Obstetrics and GynaecologyMaternal and fetal plasma levels of markers of bone metabolism in gestational diabetic pregnancies
1998, Early Human Development
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From the Perinatal Research Institute, Division of Neonatology, Departments of Pediatrics and of Obstetrics and Gynecology, University of Cincinnati Medical Center, Children's Hospital Medical Center, Cincinnati, Ohio
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Supported in part by the Diabetes in Pregnancy Program Project (HICHD 11725) and by a grant from the J. Miglierina Foundation, Varese, Italy (Dr. Demarini).
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Reprint requests: Reginald C. Tsang, MBBS, Department of Pediatrics, University of Cincinnati Medical Center, 231 Bethesda Ave., ML 541, Cincinnati, OH 45267-0541.
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0022-3476/95/$3.00 + 0 9/24/62071