engleski

FETAL GLUCOSE METABOLISM IN IDDM PREGNANCIES

In early fetal life the major determinant of growth is its genome, but in advanced pregnancy environment, hormones and nutrients influence fetal metabolism and play a central role in fetal growth. We examined the relation between glucose levels in umbilical vein/umbilical artery blood and birthwei-ght. Material and methods: Serum samples were collected from umbilical artery and vein from (1) 50 healthy eutrophic newborns and (2) 25 newborns from type-I diabetic pregnancies at the time of delivery. Blood samples were drawn into standard serum tubes; allowed to clot, separated by centrifugation, and stored at -70°C until they were studied. Insulin was determined by an RIA method, and glucose was determined by enzymatic glucose-oxydase method. Statistical analyses. Data were analyzed by standard statistical procedures using Mann Whitney test and Spearman rank order test for correlation. Statistical significance (p<0.05) was calculated with SPSS v. 10 software. All results are shown as mean ą SD. Results: As expected, healthy pregnant group was associated with significantly lower birth weight than diabetic pregnant group. There was no significant difference between the groups in maternal age or gestational age. Significant correlation was found between cord vessels glucose and insulin levels and birthweight (r=0.34; p< 0.04 and r=0.40; p<0.006, respectively). We found a parallel raise in glucose and insulin in UA and UV serum with increasing birthweight. There was significant difference between two groups in UA and UV glucose concentrations. Higher levels of glucose were found in UA in studied group 3.5ą0.7 mmol/L than in UA from normal pregnancies 2.1 ą 1.1 mmol/L. Significantly higher concentrations of glucose were found in UV in diabetic pregnancies than in UV in normal pregnancies 3.9ą0.8 mmol/L and 2.3ą1.8 mmol/L, respectively. In both groups statistically significant difference between UV-UA glucose concentrations exists, but this difference is of higher magnitude in diabetic group (p<0.05). Conclusions. The umbilical vein to umbilical artery glucose decrements means that high uptake of glucose occurs in the fetus and the levels of insulin confirm the existing autonomic fetal glucose metabolism in late pregnancy.

glucose metabolism; IDDM pregnancies

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