Ann Pediatr Endocrinol Metab.  2016 Jun;21(2):86-91. 10.6065/apem.2016.21.2.86.

Insulin and glucagon levels of umbilical cord blood in appropriate for gestational age - preterm infants with or without postnatal hypoglycemia

• Park JH
• Bae JG
• Kim S
• Kim CS
• Lee SL
• Kim HS

• KMID: 2328147
• DOI: http://doi.org/10.6065/apem.2016.21.2.86

Abstract

PURPOSE
To determine whether serum insulin and glucagon levels of umbilical cord blood correlate with subsequent postnatal hypoglycemia in appropriate for gestational age (AGA) - preterm infants at different gestational ages (GAs).
METHODS
The serum insulin and glucagon levels of umbilical cord blood were measured using magnetic bead based multiplex immunoassay in 69 AGA - premature infants, stratified according to GA: GA 23-30 weeks, early preterm (EP, n=31); GA 31-34 weeks, late preterm (LP, n=38). Postnatal hypoglycemia was defined as a capillary glucose level <40 mg/dL within the first 60 minutes of life, regardless of GA.
RESULTS
The capillary glucose concentration in EP infants (65.5±21.2 mg/dL) was significantly higher than that of LP infants (55.9±17.3 mg/dL) (P=0.043). The serum glucagon level in EP infants (44.3±28.7 pg/mL) was significantly higher than that in LP infants (28.1±13.6 pg/mL) (P=0.006). There was not a significant difference in serum insulin level between EP and LP infants (372.7±254.2 pg/mL vs. 372.4±209.1 pg/mL, P=0.996). There was a significant difference in the serum glucagon level between infants with and without hypoglycemia (27.7±8.9 mg/dL vs. 36.8±24.6 mg/dL, P=0.036), but not in the serum insulin level (451.9±256.9 pg/mL vs. 357.4±222.2 pg/mL, P=0.211). Postnatal glucose concentration within the first 60 minutes of life had a significant positive correlation with serum glucagon levels (r=0.256, P=0.034), but not with serum insulin levels (r=-0.020, P=0.867).
CONCLUSION
Lower glucagon levels of cord blood were seen in premature infants with higher GA, which might contribute to the occurrence of postnatal hypoglycemia.

Keyword

Insulin; Glucagon; Fetal blood; Hypoglycemia; Premature infant

MeSH Terms

Capillaries
Fetal Blood*
Gestational Age*
Glucagon*
Glucose
Humans
Hypoglycemia*
Immunoassay
Infant
Infant, Newborn
Infant, Premature*
Insulin*
Umbilical Cord*
Glucagon
Glucose
Insulin

Figure

• 

  Fig. 1 Serum glucagon (A) and insulin (B) levels in cord blood at birth. (C) The capillary glucose concentrations within the first 60 minutes of life. Glucagon and glucose index were significantly higher in early preterm (GA, 23–30 weeks) than in late preterm (GA, 31–34 weeks) infants. GA, gestational age. *P<0.05.

• 

  Fig. 2 Serum glucagon and insulin levels of cord blood in preterm infants with and without postnatal hypoglycemia. GA, gestational age. *P<0.05.

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