Published online May 14, 2007
PEDIATRICS Vol. 119 No. 6 June 2007, pp. e1314-e1318 (doi:10.1542/peds.2006-2589)
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ARTICLE

Perinatal Circulating Visfatin Levels in Intrauterine Growth Restriction

Ariadne Malamitsi-Puchner, MDa, Despina D. Briana, MDa, Maria Boutsikou, MDa, Evangelia Kouskouni, MDa, Demetrios Hassiakos, MDa and Demetrios Gourgiotis, PhDb

a Neonatal Division, Second Department of Obstetrics and Gynecology
b Research Laboratories, Second Department of Pediatrics, Athens University, Athens, Greece

OBJECTIVE. The objective of this study was to investigate possible alterations in circulating levels of the adipocytokine visfatin in intrauterine growth-restricted and normal pregnancies, given that these groups differ considerably in fetal nutrition, body fat mass, and metabolic/endocrine mechanisms.

METHODS. Serum visfatin levels were prospectively measured by enzyme immunoassay in 40 mothers and their 40 singleton term fetuses and neonates on postnatal days 1 and 4. Twenty neonates had intrauterine growth restriction (birth weight ≤3rd customized centile, adjusted for parameters that influence growth potential), and 20 were appropriate for gestational age.

RESULTS. Circulating maternal visfatin levels were significantly elevated in pregnancies with intrauterine growth restriction compared with control pregnancies with appropriate-for-gestational-age infants and negatively correlated with customized centiles in the group with intrauterine growth restriction. Postnatal day-1 and -4 visfatin levels were significantly higher in neonates with intrauterine growth restriction compared with neonates who were appropriate for gestational age. Postnatal-day-1 prefeeding insulin levels were significantly lower in neonates with intrauterine growth restriction.

CONCLUSIONS. Pathologic conditions in pregnancy that lead to intrauterine growth restriction could be responsible for elevated maternal visfatin levels. Higher visfatin levels in neonates with intrauterine growth restriction may serve as an early marker with prognostic value for later development of insulin resistance or type 2 diabetes, whereas lower insulin levels may indicate reduced ß-cell mass and/or impaired ß-cell function.

Key Words: intrauterine growth restriction • visfatin • fetus • neonate • insulin resistance

Abbreviations: PBEF—pre–B-cell colony-enhancing factor • IUGR—intrauterine growth restriction • AGA—appropriate for gestational age • PI—pulsatility index • N1—postnatal day 1 • N4—postnatal day 4 • CI—confidence interval

Accepted Nov 29, 2006.