Glycation of Fetal Hemoglobin Reflects Hyperglycemia Exposure In Utero: Table 1

Felix O. Dupont, Marie-France Hivert, Catherine Allard, Julie Ménard, Patrice Perron, Luigi Bouchard, Julie Robitaille, Jean-Charles Pasquier, Christiane Auray-Blais, Jean-Luc Ardilouze
2014 Diabetes Care  
OBJECTIVE The lifetime risk of metabolic diseases in offspring of women with gestational diabetes mellitus (GDM) depends, at least in part, on the impact of glycemic fetal programming. To quantify this impact, we have developed and validated a unique mass spectrometry method to measure the percentage of glycated hemoglobin in cord blood. RESEARCH DESIGN AND METHODS This case-control study includes 37 GDM women and 30 pregnant women with normal glucose tolerance (NGT). RESULTS Glycation of the
more » ... chain (Gla) was higher in neonates from GDM (2.32 vs. 2.20%, P < 0.01). Gla strongly correlated with maternal A1C measured at delivery in the overall cohort (r = 0.67, P < 0.0001) as well as in each group (GDM: r = 0.66, P < 0.0001; NGT: r = 0.50, P = 0.01). CONCLUSIONS Thus, Gla may reflect hyperglycemic exposure during the last weeks of fetal development. Future studies will confirm Gla is a predictive biomarker of prenatally programmed lifetime metabolic health and disease. The fetal programming theory suggests that maternal hyperglycemia during pregnancy has lifelong consequences for metabolic health in offspring (1,2). However, assessing fetal impacts poses a challenge. Birth weight is often used as a marker but is influenced by multiple determinants (3). Cord blood glucose, C-peptide, and insulin are also measured, albeit only once upon delivery (4-6), despite labor-associated stress and exercise affecting fetal glucose metabolism in opposite ways. A marker of long-term fetal glucose metabolism is needed. Although fetal A1C was a promising candidate, its measurement consistently resisted standard methods because of technical difficulties in face of wide biological variations (7). We have recently developed an accurate method to measure glycation of hemoglobin (Hb) chains in fetal cord blood (8). Here, we compare results from neonates born to women with gestational diabetes mellitus (GDM) and women with normal glucose tolerance (NGT). RESEARCH DESIGN AND METHODS Research Design This case-control study includes 37 women diagnosed and treated for GDM (all were under insulin therapy) and 30 pregnant women classified as NGT. This case-control
doi:10.2337/dc14-0549 pmid:25011951 fatcat:myhqdv5jh5b3tba2ztnepqh5ge