Placenta as a Link between Amino Acids, Insulin-IGF Axis, and Low Birth Weight: Evidence from Twin Studies
Rekha Bajoria,
Suren R. Sooranna,
Stuart Ward and
Maggie Hancock
University of Manchester, Academic Unit of Obstetrics and Gynecology, St. Marys Hospital for Women and Children (R.B., S.W.), Manchester, M13 OJH United Kingdom; Imperial College School of Medicine, Departments of Maternal and Fetal Medicine (S.R.S.) and Clinical Chemistry (M.H.), Chelsea and Westminster Hospital, London, SW 6 United Kingdom
Address all correspondence and requests for reprints to: Dr. Rekha Bajoria, M.D., Ph.D., St. Marys Hospital for Women and Children, Whitworth Park, Manchester, M13 OJH United Kingdom. E-mail: rbajoria{at}doctors.net.uk
Current evidence suggests that reduced placental transport ofamino acids regulates fetal growth. We determined the associationbetween fetal nutrition and the insulin-IGF axis by measuringthe plasma concentrations of amino acids, insulin, IGF-I andIGF-binding protein-1 (IGFBP-1) in maternal and cord blood fromgestational age-matched dichorionic (DC) twins with (n = 10)and without discordant birth weights (n = 10).
In the growth-restricted (IUGR) twins, fetal concentrationsof total essential (P < 0.01), nonessential (P < 0.01),and branched chain amino acids (P < 0.01) were lower thanthose in the appropriate for gestational age co-twins and concordanttwin pairs. The IUGR twins had lower fetal concentrations ofinsulin (P < 0.001) and IGF-I (P < 0.05) and higher concentrationsof IGFBP-1 (P < 0.01) than their appropriate for gestationalage co-twins. In the discordant group, fetal IGFBP-1 had a negativeassociation with fetal insulin (r = 0.71; P < 0.001), totalessential amino acids (r = 0.78; P < 0.001), and branchedchain amino acids (r = 0.64; P < 0.01). There was a positivecorrelation between total essential amino acids (r = 0.63; P< 0.001) and branched chain amino acids (r = 0.58; P <0.01) and plasma insulin. However, there were no associationsamong fetal insulin, IGFBP-1 and nonessential amino acids.
These data demonstrate the link between the reduction in certainessential and nonessential amino acids and alterations in fetalcirculating levels of insulin and IGFBP-1, in growth-restrictedtwins.
This work was supported by a grant from the Research Graduateand Support Unit, University of Manchester (Manchester, UK).
Abbreviations: AGA, Appropriate for gestational age; CI, confidenceinterval; DC, dichorionic; DZ, dizygotic; IGFBP, IGF-bindingprotein; IUGR, intrauterine growth-restricted; MZ, monozygotic.
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