Peripartum maternal and foetal ghrelin, growth hormones, IGFs and insulin interrelations.
OBJECTIVE
Ghrelin may influence GH secretion and is associated with insulin sensitivity. In pregnancy, placental growth hormone (PGH) replaces GH. The aim of this study was to investigate the relationship between PGH and ghrelin and their relationship to insulin sensitivity in pregnancy.


METHODS
Prospective, descriptive study.


METHODS
Thirty-seven singleton pregnant and six twin pregnant women


METHODS
Maternal blood samples were drawn before and 2 days after elective caesarian section (CS). Serum total ghrelin, PGH, GH, GH-binding protein, insulin and IGF-I and IGF-II, and plasma glucose were determined. Insulin sensitivity indices (ISIs) were calculated. Cord blood samples were drawn at delivery for ghrelin determination.


RESULTS
Serum ghrelin only displayed a minimal, although statistically significant, decrease after CS. Prior to delivery serum PGH increased by 25% during fasting, and was undetectable the day after CS. Serum levels of GH were low until 48 h after CS. No significant correlations were detected between PGH or ghrelin and ISIs, although a trend was observed for ghrelin. Twin pregnancies had higher PGH levels than singletons; however, levels of IGFs were similar. In cord blood, ghrelin levels were higher in arterial than venous samples.


CONCLUSIONS
Maternal ghrelin levels were only minimally affected by parturition, suggesting that maternal ghrelin is not involved in the transition from PGH to GH secretion. The increased arterial ghrelin levels in the foetus suggest foetal ghrelin production. Serum PGH appears to be influenced by fasting. Finally, elevated PGH levels in twin pregnancies do not appear to affect maternal IGF levels.
Fuglsang
Jens
J
Gynaecological/Obstetrical Research Laboratory, Aarhus University Hospital, Skejby Sygehus, DK-8200 Aarhus N, Denmark. fuglsang@ki.au.dk
Sandager
Puk
P
Møller
Niels
N
Fisker
Sanne
S
Frystyk
Jan
J
Ovesen
Per
P
D000328:Adult; D000704:Analysis of Variance; D001786:Blood Glucose / Q000032:analysis; D002585:Cesarean Section; D005260:Female; D005865:Gestational Age; D054439:Ghrelin; D013006:Growth Hormone / Q000097:blood*; D006801:Humans; D007231:Infant, Newborn; D007328:Insulin / Q000097:blood*; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D007335:Insulin-Like Growth Factor II / Q000032:analysis; D008297:Male; D036361:Peptide Hormones / Q000097:blood*; D010926:Placental Hormones / Q000097:blood*; D011247:Pregnancy; D011272:Pregnancy, Multiple / Q000097:blood*; D011446:Prospective Studies; D013002:Somatomedins / Q000032:analysis*; D014427:Twins
D001786:Blood Glucose; C064980:GH2 protein, human; D054439:Ghrelin; D007328:Insulin; D036361:Peptide Hormones; D010926:Placental Hormones; D013002:Somatomedins; D007334:Insulin-Like Growth Factor I; D007335:Insulin-Like Growth Factor II; D013006:Growth Hormone