Serum insulin-like growth factor-I (IGF-I) IGF binding protein-3 (IGFBP-3) and leptin levels are related to abdominal aortic intima-media thickness in macrosomic newborns

ObjectiveExposure to diabetes in utero has been established as a significant risk factor for some of the components of metabolic syndrome, and was associated with increased levels of maternal, placental, and fetal insulin-like growth factors and leptin. The atherogenic effects of leptin and insulin-like growth factor-I (IGF-I) have been extensively described. The present study was therefore designed to investigate relationships between abdominal aortic intima-media thickness (aIMT), serum IGF-I, IGF binding protein-3 (IGFBP-3) and leptin levels in macrosomic newborns.DesignNeonates whose birth weights exceed 90th percentile for gestational age and gender are termed macrosomic. Abdominal aortic intima-media thickness was measured in 30 macrosomic neonates of diabetic mothers (group A), 30 macrosomic neonates of healthy mothers (group B) and 30 healthy neonates (group C). Serum IGF-I, IGFBP-3 and leptin levels were determined in all infants and their mothers. Stepwise logistic regression analysis was used to determine independent risk factors for aortic intima-media thickness.ResultsMean aortic intima-media thickness was significantly higher in groups A and B (0.489 ± 0.015, 0.466 ± 0.019 mm, respectively) than in controls (0.375 ± 0.024 mm, p < 0.0001). Weight-adjusted aortic intima-media thickness was significantly higher in-group A than in groups B (p = 0.004) and C (p = 0.048). Serum leptin concentration in-group B (37.4 ± 10.7 ng/ml) was significantly greater than in-group C (23.5 ± 7.1 ng/ml, p < 0.0001), but significantly lower than in-group A (46.6 ± 14.1 ng/ml, p < 0.0001). Serum IGF-I levels of the infants were significantly lower in-group C (113.2 ± 33.1 ng/ml) than in groups A and B (205.2 ± 60.1 and 179.3 ± 55.1 ng/ml respectively, p < 0.0001). Serum IGF-I, IGFBP-3 and leptin levels of the infants were positively correlated with mean (p < 0.0001) and weight-adjusted aortic intima-media thickness measurements (p = 0.003, p = 0.006 and p = 0.001, respectively).ConclusionsMacrosomic neonates of diabetic mothers have significantly increased aortic intima-media thickness with higher serum IGF-I, IGFBP-3 and leptin concentrations than those of controls. It might be speculated that these changes may exaggerate the atherosclerotic process later in life.