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Serum Levels of Somatomedins and Somatomedin-Binding Protein in Pregnant Women with Type I or Gestational Diabetes and Their Infants^*

KERSTIN HALL, ULF HANSSON, GUNNEL LUNDIN, MARGUERITE LUTHMAN, BENGT PERSSON, GUILHERME PÓVOA, MAGNUS STANGENBERG and ULRIKA ÖFVERHOLM

Departments of Endocrinology and Obstetrics and Gynecobgy, Karolinska Hospital, and the Department of Pediatrics, St Göran's Children's Hospital Stockholm, Sweden

Address requests for reprints to: Dr. Kerstin Hall, Department of Endocrinology, Karolinska Institutet, Box 60500, Stockholm, S-10401, Sweden.

The serum levels of the low mol wt form of somatomedin-binding protein (SMBP) were 5-fold higher in both diabetic (n = 44) and nondiabetic pregnant women (n = 14) than in nonpregnant women. No difference was found between women with type 1 diabetes and those with gestational diabetes.

There was a negative correlation between maternal levels of SMBP during the last trimester and the birth weight percentile of the infants (r = –0.51). There was a 2- to 3-fold elevation of maternal insulin-like growth factor (IGF-I) levels during pregnancy in both diabetic and nondiabetic women. A positive correlation (r = 0.49) was found between maternal IGF-I levels and the birth weight percentiles of their infants. The correlation between the ratio of IGF-I to SMBP, which may reflect the IGFI available to the placenta, to birth weight percentile was higher (r = 0.57), and the SE of estimate of weight percentile was 23%. The ratio between IGF-I and SMBP in cord blood was correlated with birth weight, although cord blood IGF-I and SMBP values were not. The IGF-II levels in cord serum were 50% higher in the infants of diabetic than in those of nondiabetic mothers.

These findings raise the questions of whether maternal SMBP levels influence the amount of IGF-I available for the fetal-placental unit and whether IGF-II participates in glucose homeostasis in the fetus.

^* This work was supported by grants from the Swedish Medical Research Council (no. 4224 and 3787).

Recipient of a scholarship from CAPES/Education and Culture Ministry, Brazil.

Received January 16, 1986.

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