Chapters authored
Hypercortisolaemia and Hyperinsulinaemia Interaction and their Impact upon Insulin Resistance/Sensitivity Markers at Birth
Information on insulin resistance/sensitivity in term-normoweight neonates is scarce. The hypothalamus-pituitary-adrenal cortex axis and pancreas are implicated in several aspects of foetal maturation and programming. This study aims to analyse the effects of a combination of hyperinsulinaemia plus hypercortisolaemia in such neonates together with their mothers℉ gestational glucose tolerance on growth hormone (GH), insulin-like growth factor-1 (IGF)-1, glucose, and insulin resistance/sensitivity markers [homeostatic model assessment-insulin resistance (HOMA-IR)/quantitative insulin sensitivity check index (QUICKI)] at birth. Furthermore, the importance of pregnancy diet quality on these markers is discussed. In a selected group of 187 term-normoweight non-distressed neonates, about 9% had increased insulin and cortisol cord-blood concentrations. In spite of normality criteria applied, the combination of hypercortisolaemia and hyperinsulinaemia at birth was associated with higher body weight, body length, glucose, HOMA-IR, GH, IGF-1 and glucose/insulin ratio values than those of neonates presenting low/normal concentrations of insulin and cortisol. Hyperinsulinaemia preferentially to hypercortisolaemia affected the markers studied. Impaired glucose tolerance prevalence was higher in mothers whose neonates were hyperinsulinaemic at birth. The hyperinsulinaemic plus hypercortisolaemic status was more prevalent in neonates whose mothers had poor Mediterranean diet adherence. Results show the importance of analysing insulin and cortisol in cord-blood even in term-normoweight neonates.
Part of the book: Umbilical Cord Blood Banking for Clinical Application and Regenerative Medicine