Placental Structure in Type 1 Diabetes Relation to Fetal Insulin, Leptin, and IGF-I

Scott M. Nelson; Philip M. Coan; Graham J. Burton; Robert S. Lindsay

doi:10.2337/db09-0739

Placental Structure in Type 1 Diabetes Relation to Fetal Insulin, Leptin, and IGF-I

Scott M. Nelson^*, Philip M. Coan, Graham J. Burton, Robert S. Lindsay

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract / Description of output

OBJECTIVE-Alteration of placental structure may influence fetal overgrowth and complications of maternal diabetes. We examined the placenta in a cohort of offspring of mothers with type I diabetes (OT1DM) to assess structural changes and determine whether these were related to maternal A1C, fetal hematocrit, fetal hormonal, or metabolic axes.

RESEARCH DESIGN AND METHODS-Placental samples were analyzed using stereological techniques to quantify volumes and surface areas of key placental components in 88 OT1DM and 39 control subjects, and results related to maternal A1C and umbilical cord analytes (insulin, leptin, adiponectin, IGF-I, hematocrit, lipids, C-reactive protein, and interleukin-6).

RESULTS-Intervillous space volume was increased in OT1DM (OT1DM 250 +/- 81 cm(3) VS. control 217 +/- 65 cm(3); P = 0.02) with anisomorphic growth of villi (P = 0.025). The placentas showed a trend to increased weight (OT1DM 690 +/- 19 g; control 641 +/- 22 g; P = 0.08), but villous, nonparenchymal, trophoblast, and capillary volumes did not differ. Villous surface area, capillary surface area, membrane thickness, and calculated morphometric diffusing capacity were also similar in type 1 diabetic and control subjects. A1C at 26-34 weeks associated with birth weight (r = 0.27, P = 0.03), placental weight (r = 0.41, P = 0.0009), and intervillous space volume (r = 0.38, P = 0.0024). In multivariate analysis of cord parameters in OT1DM, fetal IGF-I emerged as a significant correlate of most components (intervillous space, villous, trophoblast, and capillary volumes, all P <0.01). By contrast, fetal insulin was only independently associated with capillary surface area (positive, r(2) = 6.7%; P = 0.02).

CONCLUSIONS-There are minimal placental structural differences between OT1DM and control subjects. Fetal IGF-I but not fetal insulin emerges as a key correlate of placental substructural volumes, thereby facilitating feedback to the placenta regarding fetal metabolic demand. Diabetes 58:2634-2641, 2009

Original language	English
Pages (from-to)	2634-2641
Number of pages	8
Journal	Diabetes
Volume	58
Issue number	11
DOIs	https://doi.org/10.2337/db09-0739
Publication status	Published - Nov 2009

Keywords / Materials (for Non-textual outputs)

GROWTH-FACTOR-I
CARBOHYDRATE-METABOLISM
INTERVILLOUS PORES
POSTNATAL-GROWTH
BIRTH-WEIGHT
CORD BLOOD
PREGNANCIES
MOTHERS
WOMEN
MELLITUS

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10.2337/db09-0739

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@article{e9bd7b7d6e524443aa0b40c04e082884,

title = "Placental Structure in Type 1 Diabetes Relation to Fetal Insulin, Leptin, and IGF-I",

abstract = "OBJECTIVE-Alteration of placental structure may influence fetal overgrowth and complications of maternal diabetes. We examined the placenta in a cohort of offspring of mothers with type I diabetes (OT1DM) to assess structural changes and determine whether these were related to maternal A1C, fetal hematocrit, fetal hormonal, or metabolic axes.RESEARCH DESIGN AND METHODS-Placental samples were analyzed using stereological techniques to quantify volumes and surface areas of key placental components in 88 OT1DM and 39 control subjects, and results related to maternal A1C and umbilical cord analytes (insulin, leptin, adiponectin, IGF-I, hematocrit, lipids, C-reactive protein, and interleukin-6).RESULTS-Intervillous space volume was increased in OT1DM (OT1DM 250 +/- 81 cm(3) VS. control 217 +/- 65 cm(3); P = 0.02) with anisomorphic growth of villi (P = 0.025). The placentas showed a trend to increased weight (OT1DM 690 +/- 19 g; control 641 +/- 22 g; P = 0.08), but villous, nonparenchymal, trophoblast, and capillary volumes did not differ. Villous surface area, capillary surface area, membrane thickness, and calculated morphometric diffusing capacity were also similar in type 1 diabetic and control subjects. A1C at 26-34 weeks associated with birth weight (r = 0.27, P = 0.03), placental weight (r = 0.41, P = 0.0009), and intervillous space volume (r = 0.38, P = 0.0024). In multivariate analysis of cord parameters in OT1DM, fetal IGF-I emerged as a significant correlate of most components (intervillous space, villous, trophoblast, and capillary volumes, all P <0.01). By contrast, fetal insulin was only independently associated with capillary surface area (positive, r(2) = 6.7%; P = 0.02).CONCLUSIONS-There are minimal placental structural differences between OT1DM and control subjects. Fetal IGF-I but not fetal insulin emerges as a key correlate of placental substructural volumes, thereby facilitating feedback to the placenta regarding fetal metabolic demand. Diabetes 58:2634-2641, 2009",

keywords = "GROWTH-FACTOR-I, CARBOHYDRATE-METABOLISM, INTERVILLOUS PORES, POSTNATAL-GROWTH, BIRTH-WEIGHT, CORD BLOOD, PREGNANCIES, MOTHERS, WOMEN, MELLITUS",

author = "Nelson, {Scott M.} and Coan, {Philip M.} and Burton, {Graham J.} and Lindsay, {Robert S.}",

year = "2009",

month = nov,

doi = "10.2337/db09-0739",

language = "English",

volume = "58",

pages = "2634--2641",

journal = "Diabetes ",

issn = "0012-1797",

publisher = "AMER DIABETES ASSOC",

number = "11",

}

TY - JOUR

T1 - Placental Structure in Type 1 Diabetes Relation to Fetal Insulin, Leptin, and IGF-I

AU - Nelson, Scott M.

AU - Coan, Philip M.

AU - Burton, Graham J.

AU - Lindsay, Robert S.

PY - 2009/11

Y1 - 2009/11

N2 - OBJECTIVE-Alteration of placental structure may influence fetal overgrowth and complications of maternal diabetes. We examined the placenta in a cohort of offspring of mothers with type I diabetes (OT1DM) to assess structural changes and determine whether these were related to maternal A1C, fetal hematocrit, fetal hormonal, or metabolic axes.RESEARCH DESIGN AND METHODS-Placental samples were analyzed using stereological techniques to quantify volumes and surface areas of key placental components in 88 OT1DM and 39 control subjects, and results related to maternal A1C and umbilical cord analytes (insulin, leptin, adiponectin, IGF-I, hematocrit, lipids, C-reactive protein, and interleukin-6).RESULTS-Intervillous space volume was increased in OT1DM (OT1DM 250 +/- 81 cm(3) VS. control 217 +/- 65 cm(3); P = 0.02) with anisomorphic growth of villi (P = 0.025). The placentas showed a trend to increased weight (OT1DM 690 +/- 19 g; control 641 +/- 22 g; P = 0.08), but villous, nonparenchymal, trophoblast, and capillary volumes did not differ. Villous surface area, capillary surface area, membrane thickness, and calculated morphometric diffusing capacity were also similar in type 1 diabetic and control subjects. A1C at 26-34 weeks associated with birth weight (r = 0.27, P = 0.03), placental weight (r = 0.41, P = 0.0009), and intervillous space volume (r = 0.38, P = 0.0024). In multivariate analysis of cord parameters in OT1DM, fetal IGF-I emerged as a significant correlate of most components (intervillous space, villous, trophoblast, and capillary volumes, all P <0.01). By contrast, fetal insulin was only independently associated with capillary surface area (positive, r(2) = 6.7%; P = 0.02).CONCLUSIONS-There are minimal placental structural differences between OT1DM and control subjects. Fetal IGF-I but not fetal insulin emerges as a key correlate of placental substructural volumes, thereby facilitating feedback to the placenta regarding fetal metabolic demand. Diabetes 58:2634-2641, 2009

AB - OBJECTIVE-Alteration of placental structure may influence fetal overgrowth and complications of maternal diabetes. We examined the placenta in a cohort of offspring of mothers with type I diabetes (OT1DM) to assess structural changes and determine whether these were related to maternal A1C, fetal hematocrit, fetal hormonal, or metabolic axes.RESEARCH DESIGN AND METHODS-Placental samples were analyzed using stereological techniques to quantify volumes and surface areas of key placental components in 88 OT1DM and 39 control subjects, and results related to maternal A1C and umbilical cord analytes (insulin, leptin, adiponectin, IGF-I, hematocrit, lipids, C-reactive protein, and interleukin-6).RESULTS-Intervillous space volume was increased in OT1DM (OT1DM 250 +/- 81 cm(3) VS. control 217 +/- 65 cm(3); P = 0.02) with anisomorphic growth of villi (P = 0.025). The placentas showed a trend to increased weight (OT1DM 690 +/- 19 g; control 641 +/- 22 g; P = 0.08), but villous, nonparenchymal, trophoblast, and capillary volumes did not differ. Villous surface area, capillary surface area, membrane thickness, and calculated morphometric diffusing capacity were also similar in type 1 diabetic and control subjects. A1C at 26-34 weeks associated with birth weight (r = 0.27, P = 0.03), placental weight (r = 0.41, P = 0.0009), and intervillous space volume (r = 0.38, P = 0.0024). In multivariate analysis of cord parameters in OT1DM, fetal IGF-I emerged as a significant correlate of most components (intervillous space, villous, trophoblast, and capillary volumes, all P <0.01). By contrast, fetal insulin was only independently associated with capillary surface area (positive, r(2) = 6.7%; P = 0.02).CONCLUSIONS-There are minimal placental structural differences between OT1DM and control subjects. Fetal IGF-I but not fetal insulin emerges as a key correlate of placental substructural volumes, thereby facilitating feedback to the placenta regarding fetal metabolic demand. Diabetes 58:2634-2641, 2009

KW - GROWTH-FACTOR-I

KW - CARBOHYDRATE-METABOLISM

KW - INTERVILLOUS PORES

KW - POSTNATAL-GROWTH

KW - BIRTH-WEIGHT

KW - CORD BLOOD

KW - PREGNANCIES

KW - MOTHERS

KW - WOMEN

KW - MELLITUS

U2 - 10.2337/db09-0739

DO - 10.2337/db09-0739

M3 - Article

SN - 0012-1797

VL - 58

SP - 2634

EP - 2641

JO - Diabetes

JF - Diabetes

IS - 11

ER -

Placental Structure in Type 1 Diabetes Relation to Fetal Insulin, Leptin, and IGF-I

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