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Size at Birth and Cord Blood Levels of Insulin, Insulin-Like Growth Factor I (IGF-I), IGF-II, IGF-Binding Protein-1 (IGFBP-1), IGFBP-3, and the Soluble IGF-II/Mannose-6-Phosphate Receptor in Term Human Infants¹

Department of Paediatrics, University of Cambridge, Addenbrookes Hospital (K.O., D.D.), Cambridge, United Kingdom CB2 2QQ; Universitätskinderklinik und Poliklinik, University of Leipzig (J.K., W.K.), Leipzig, 04317 Germany; Unit of Pediatric and Perinatal Epidemiology, University of Bristol (ALSPAC Study Team), Bristol, United Kingdom BS8 1TQ; and Kolling Institute for Medical Research, University of Sydney, Royal North Shore Hospital (M.C., C.S.), New South Wales 2006, Australia

Address all correspondence and requests for reprints to: Prof. David B. Dunger, Department of Paediatrics, Level 8, Addenbrookes Hospital, Box 116, Cambridge, United Kingdom CB2 2QQ. E-mail: dbd25{at}cam.ac.uk

Experimental rodent studies demonstrate that insulin-like growth factor II (IGF-II) promotes fetal growth, whereas the nonsignaling IGF-II receptor (IGF2R) is inhibitory; in humans their influence is as yet unclear. A soluble, circulating form of IGF2R inhibits IGF-II mediated DNA synthesis and may therefore restrain fetal growth. We measured cord blood levels of IGF-II, soluble IGF2R, insulin, IGF-I, IGF-binding protein-1 (IGFBP-1), and IGFBP-3 and examined their relationships to weight, length, head circumference, ponderal index, and placental weight at birth in 199 normal term singletons. IGF-II levels correlated with levels of IGF-I (r = 0.29; P < 0.0005), IGFBP-3 (r = 0.45; P < 0.0005), and soluble IGF2R (r = 0.20; P < 0.005). Insulin and IGF-I were positively related to all parameters of size at birth. IGF-II was weakly related to ponderal index (r = 0.18; P < 0.05) and placental weight (r = 0.18; P < 0.05), and the molar ratio of IGF-II to IGF2R was also related to birth weight (r = 0.15; P < 0.05). Correlations between the IGFs and size at birth were stronger in nonprimiparous pregnancies; in these, IGF-I (r = 0.52; P < 0.0005), IGFBP-3 (r = 0.41; P < 0.0005), and the IGF-II to IGF2R ratio (r = 0.40; P < 0.0005) were most closely related to placental weight, together accounting for 39% of its variance. We demonstrate for the first time relationships between circulating IGF-II and soluble IGF2R levels and size at birth, supporting their putative opposing roles in human fetal growth.

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