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Clinical Chemistry 54: 550-558, 2008. First published January 17, 2008; 10.1373/clinchem.2007.095299
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(Clinical Chemistry. 2008;54:550-558.)
© 2008 American Association for Clinical Chemistry, Inc.

Pediatric Clinical Chemistry

Ghrelin, Leptin, IGF-1, IGFBP-3, and Insulin Concentrations at Birth: Is There a Relationship with Fetal Growth and Neonatal Anthropometry?

Claudio Chiesa1,3,a, John F. Osborn2, Cristina Haass4, Fabio Natale1, Marina Spinelli4, Eleonora Scapillati4, Angela Spinelli5 and Lucia Pacifico1,3

Departments of1 Pediatrics and2 Public Health Science, La Sapienza University of Rome;3 National Research Council, Rome;4 Villa San Pietro Hospital, Rome;5 National Institute of Health, Rome, Italy.

aAddress correspondence to this author at: Department of Pediatrics, La Sapienza University of Rome, Viale Regina Elena, 324 00161 Rome, Italy. Fax 39-06-4997-9215; e-mail claudio.chiesa{at}uniroma1.it.

Background: Insulin, growth hormone (GH), and growth factors (insulin-like growth factors [IGFs] and their binding proteins [IGFBPs]) are known to influence fetal growth and also the synthesis/secretion of the recently discovered hormones leptin and ghrelin.

Methods: In 153 delivering mothers and their offspring at birth, we prospectively investigated the association between mothers’ and babies’ serum concentrations of ghrelin, leptin, insulin, IGF-1, and IGFBP-3 and neonatal anthropometric characteristics and the growth of the fetus. We also tried to put babies’ serum glucose and GH measurements in this context.

Results: Birth weight (BW), birth length, head circumference, and ponderal index (PI) were positively associated with cord IGF-1, IGFBP-3, and leptin and negatively associated with GH. BW was independently associated with maternal stature and prepartum weight, birth length with maternal stature, PI with maternal insulin and prepartum weight, and head circumference with maternal ghrelin. Compared with preterm infants whose development was appropriate for gestational age (AGA), preterm growth-restricted babies displayed alteration in GH-IGF axis (increased GH and low IGF-1 and IGFBP-3 concentrations), low leptin and glucose concentrations, and increased ghrelin concentrations. In large-for-gestational-age (LGA) babies, leptin, IGFBP-3, insulin, and glucose concentrations were significantly higher in asymmetric LGA newborns than in symmetric LGA and AGA newborns.

Conclusions: We found relationships between metabolic factors, fetal growth, and anthropometry. Intrauterine growth restriction involved alteration in the fetal GH-IGF axis, with relatively low leptin and glucose concentrations and increased ghrelin concentrations. Leptin, insulin, and IGFBP-3 delineated subtypes of fetal overgrowth.




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