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Type 1 Collagen Marker of Bone Turnover, Insulin-Like Growth Factor, and Leptin in Dichorionic Twins with Discordant Birth Weight

Academic Unit of Obstetrics and Gynaecology (R.B.), St. Mary’s Hospital for Women and Children, Manchester M13 0JH, United Kingdom; Department of Maternal and Fetal Medicine (S.R.S.), Chelsea and Westminster Hospital, London SW10 9NH, United Kingdom; and Reproductive Medicine Unit (R.C.), University College London, London WC1E 6HX, United Kingdom

Address all correspondence and requests for reprints to: Ratna Chatterjee, M.D., Ph.D., University College London, Department of Obstetrics and Gynaecology, 88-96 Chenies Mews, London WC1E 6HX, United Kingdom. E-mail: r.chatterjee{at}ucl.ac.uk.

Objective: We investigated the relationship between IGF-I-IGF binding protein (IGFBP)-1 and leptin levels with type 1 collagen markers of bone turnover in dichorionic twins with or without discordant birth weight of 20% or greater.

Methods: Maternal and cord bloods were collected from gestational age-matched dichorionic twins with (n = 16) or without (n = 16) discordant birth weight. The samples were assayed for cross-linked carboxyl terminal telopeptide (ICTP, a marker of bone resorption) and propeptide (PICP, a marker of bone formation) of type I collagen, leptin, IGF-I, and IGFBP-1 by RIA.

Results: The intrauterine growth-restricted (IUGR) twins of the discordant group had higher fetal ICTP (P < 0.001) and IGFBP-1 (P < 0.001) levels, whereas PICP (P < 0.001), IGF-I (P < 0.001), and leptin (P < 0.001) were lower than the cotwins with normal weight (AGA). In contrast, concentrations of IGF-I, IGFBP-1, ICTP, PICP, and leptin were comparable between concordant twin pairs. Leptin levels were positively correlated with PICP (r = 0.61; P < 0.001) and negatively with ICTP (r = –0.57; P < 0.001) in concordant and AGA twins but not in IUGR twins. In IUGR twins, IGF-I had positive association with PICP (r = 0.76; P < 0.001) and negative association with ICTP (r= –0.76; P < 0.001), whereas IGFBP-1 was negatively correlated with PICP levels (r = –0.65; P < 0.01). No such association was found in concordant and AGA twins.

Conclusion: These data suggest that IUGR twins had high bone turnover, which is independent of maternal factors and perhaps may be due to altered IGF axis.

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