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Clinical Chemistry 51: 2296-2302, 2005. First published September 22, 2005; 10.1373/clinchem.2005.056077
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(Clinical Chemistry. 2005;51:2296-2302.)
© 2005 American Association for Clinical Chemistry, Inc.

Endocrinology and Metabolism

Increased Plasma Pro-B-Type Natriuretic Peptide in Infants of Women with Type 1 Diabetes

Karen G. Halse1,2, Marie L.S. Lindegaard1, Jens P. Goetze1, Peter Damm2, Elisabeth R. Mathiesen3 and Lars B. Nielsen1,a

Departments of1 Clinical Biochemistry, 2 Obstetrics, and 3 Endocrinology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

aAddress correspondence to this author at: Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. Fax 45-35452524; e-mail Larsbo{at}rh.dk.

Background: Up to 40% of newborn infants of women with type 1 diabetes have echocardiographic signs of cardiomyopathy. Increased plasma concentrations of B-type natriuretic peptide (BNP) and its precursor (proBNP) are markers of cardiac failure and hypoxia in adults. In this study, we investigated whether plasma concentrations of proBNP and/or BNP are increased in infants of women with type 1 diabetes.

Methods: Plasma BNP and proBNP were measured with RIAs. The proBNP assay measures both intact proBNP and NH2-terminal fragments derived from this precursor, whereas the BNP assay measures only BNP-32 and not proBNP.

Results: Infants of women with diabetes and hemoglobin A1c (Hb A1c) ≥6.2% before delivery had a higher median plasma proBNP concentration (31 pmol/L; interquartile range, 21–47 pmol/L; n = 16) than infants of healthy women [16 (9–32) pmol/L; n = 21; P = 0.01]. Infants of women with diabetes and Hb A1c <6.2% (n = 15) had intermediate values. The plasma BNP and proBNP concentrations were closely associated (r2 = 0.80; P <0.0001); within the group of infants of women with diabetes and Hb A1c ≥6.2%, both correlated with the degree of fetal stress during labor.

Conclusions: Maternal diabetes and suboptimal metabolic control may affect the fetal heart and predominantly stimulate proBNP secretion in conjunction with perinatal stress.




The following articles in journals at HighWire Press have cited this article:


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A. E. Malavazos, L. Morricone, A. Marocchi, F. Ermetici, B. Ambrosi, and M. M. Corsi
N-terminal pro-B-type natriuretic Peptide and echocardiographic abnormalities in severely obese patients: correlation with visceral fat.
Clin. Chem., June 1, 2006; 52(6): 1211 - 1213.
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