title: Cord serum dipeptidyl-peptidase 4 activity in gestational diabetes.
abstract: BACKGROUND
  Tissue-specific dipeptidyl-peptidase 4 (DPP4) dysregulation has been described in adults with diabetes mellitus. The DPP4 -incretin system has not been studied in foetal life. In this study, DPP4 activity and glucagon-like peptide-1 (GLP-1) levels were assessed in cord blood of neonates born to women with gestational diabetes mellitus (GDM) and nondiabetic controls.
  
  
  METHODS
  This study has been conducted in two Hungarian and one Austrian centres.
  
  
  METHODS
  A total of 568 pregnant women were enrolled in the study after their OGTT between the 24th and 28th gestational week. Cord blood samplings with DPP4 activity and GLP-1 level measurements were possible in 270 (DPP4: 159 control, 111 GDM) and 112 (GLP-1: 72 control, 40 GDM) cases. OGTT (24-28th gestational week) and cord blood sampling at delivery were performed. Cord serum DPP4 activity was determined in a continuous monitoring microplate-based kinetic assay, and cord plasma GLP-1 was measured using a fluorescence ELISA method.
  
  
  RESULTS
  Cord serum DPP4 activity was lower in GDM [mean (95% CI): 28.07 U/L (26.32-29.82 U/L)] than in controls [31.61 U/L (29.93-33.29 U/L), MWU P = 0.0015]. Cord plasma active GLP-1 levels were close to the lower detection limit and were not altered in GDM (control: mean = 3.43 pM, 95% CI: 3.04-3.82 pM, GDM: mean = 3.61 pM, 95% CI: 2.96-4.28 pM - MWU test P = 0.6).
  
  
  CONCLUSIONS
  Decreased cord serum DPP4 activity in gestational diabetes mellitus might be the result of an adaptive foetal response or an early dysregulation in the entero-insular axis with consequences beyond the incretin system. Cord plasma GLP-1 levels may reflect the missing oral intake with a limited glucose sensing of L cells via the circulation in foetal life.
authors.affiliation: 2nd Department of Internal Medicine, Semmelweis University, Budapest, Hungary.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Al-Aissa
authors.forename: Klára
authors.initials: K
authors.lastname: Rosta
authors.forename: Orsolya
authors.initials: O
authors.lastname: Hadarits
authors.forename: Jürgen
authors.initials: J
authors.lastname: Harreiter
authors.forename: András
authors.initials: A
authors.lastname: Zóka
authors.forename: Dagmar
authors.initials: D
authors.lastname: Bancher-Todesca
authors.forename: Attila
authors.initials: A
authors.lastname: Patócs
authors.forename: Katalin
authors.initials: K
authors.lastname: Kiss
authors.forename: Beatrix
authors.initials: B
authors.lastname: Sármán
authors.forename: Péter
authors.initials: P
authors.lastname: Pusztai
authors.forename: István
authors.initials: I
authors.lastname: Sziller
authors.forename: János
authors.initials: J
authors.lastname: Rigó
authors.forename: Károly
authors.initials: K
authors.lastname: Rácz
authors.forename: Anikó
authors.initials: A
authors.lastname: Somogyi
authors.forename: Alexandra
authors.initials: A
authors.lastname: Kautzky-Willer
authors.forename: Gábor
authors.initials: G
authors.lastname: Firneisz
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D016022:Case-Control Studies; D016640:Diabetes, Gestational / Q000178:diet therapy / Q000188:drug therapy / Q000201:enzymology*; D018819:Dipeptidyl Peptidase 4 / Q000378:metabolism*; D005260:Female; D005312:Fetal Blood / Q000378:metabolism*; D052216:Glucagon-Like Peptide 1 / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D061385:Insulins / Q000627:therapeutic use; D011247:Pregnancy; D011256:Pregnancy Outcome
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D061385:Insulins; D052216:Glucagon-Like Peptide 1; D018819:Dipeptidyl Peptidase 4
keywords: Cord blood; dipeptidyl-peptidase 4 (DPP4); gestational diabetes mellitus (GDM); glucagon-like peptide-1 (GLP-1); pregnancy