Cord Blood Levels of Insulin, Cortisol and HOMA2-IR in Very Preterm, Late Preterm and Term NewbornsCorrespondence Address :
Dr. Rukmini Mysore Srikantiah,
Associate Professor, Department of Biochemistry, Center for Basic Sciences, Kasturba Medical College, Bejai,
Mangalore, Karnataka-575004, India.
Introduction: Alteration in the glucose homeostasis is still the major cause of morbidity and mortality in the newborns. Intrauterine undernutrition plays an important role in causing adult insulin resistance and diabetes but the exact cause is still unknown.
Aim: To estimate the plasma glucose, serum insulin and cortisol levels at birth in newborns at different gestational age.
Materials and Methods: The present cross-sectional study conducted from December 2014 to June 2015 included 58 newborns enrolled as per the inclusion criteria and further categorized into Group I (very preterm; n=19; gestational age < 32 weeks), Group II (late preterm; n=20; gestational age between 32-37 weeks) and Group III (full term; n=19; gestational age >37 weeks) newborns. Venous Cord Blood (VCB) was collected and plasma glucose was analysed by GOD-POD (Glucose Oxidase-Peroxidase) method in auto analyser whereas serum insulin and cortisol were analysed by ELISA (Enzyme Linked Immunosorbent Assay). HOMA2-IR (Homeostatic Model Assessment) calculator was used to assess insulin resistance. All parametric data was expressed as mean±SD and analysed using ANOVA with Tukey’s as the Post-Hoc test. Correlation analysis was done using Pearson’s correlation co-efficient with scatter plot as the graphical representation.
Results: Significantly increased insulin and HOMA2-IR levels were found in group I (13.7±4.7µIU/mL and 1.6±0.58 respectively) when compared to group II (8.3±2.9µIU/mL and 0.93±0.2 respectively) and group III (8.3±2.1µIU/mL and 1.03±0.26 respectively). A positive correlation between cortisol levels and gestational age (r = 0.6, n = 58, p < 0.001) and a negative correlation between insulin and gestational age (r = -0.654, n = 58, p < 0.001) was observed in the study population.
Conclusion: Increased levels of insulin and HOMA2-IR as seen in the very preterm newborns signify the predisposition of these newborns to development of diabetes in later stages of life. The inverse association of cortisol and insulin with gestational age suggests that cortisol could also be responsible for impaired ß cell function and insulin sensitivity.
Insulin resistance, Neonates, Postnatal life
Afzal Ahmad, Rukmini Mysore Srikantiah, Charu Yadav, Ashish Agarwal, Poornima Ajay Manjrekar, Anupama Hegde. CORD BLOOD LEVELS OF INSULIN, CORTISOL AND HOMA2-IR IN VERY PRETERM, LATE PRETERM AND TERM NEWBORNS. Journal of Clinical and Diagnostic Research [serial online] 2016 May [cited: 2018 Oct 19 ]; 10:BC05-BC08. Available from
Date of Submission: Jan 08, 2016
Date of Peer Review: Feb 03, 2016
Date of Acceptance: Feb 18, 2016
Date of Publishing: May 01, 2016
Financial OR OTHER COMPETING INTERESTS: As declare above.
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