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Umbilical cord serum insulin-like growth factor-1 levels of infants of diabetic mothers are correlated with diastolic dysfunction detected by tissue Doppler echocardiography

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Abstract

Tissue Doppler echocardiography (TDI) is a convenient method to detect cardiac dysfunction in the infants of diabetic mothers (IDMs). Umbilical cord serum insulin-like growth factor-1 (IGF-1) is known to be higher in IDMs. We aimed to determine whether there is a relation between diastolic functions examined by TDI and cord serum IGF-1 levels of IDMs. Cord serum IGF-1 levels of 32 IDMs and 22 healthy infants were measured. The cardiac functions of the infants were evaluated by M-Mode and TDI. For statistical analysis, Mann–Whitney U and Spearman correlation tests were used for continuous variables, and the chi-square test was used for categorical variables. The cord serum IGF-1 levels of the IDMs were higher (p = 0.000). The left ventricle (LV) e', LVa', LV e'/a', and LV Tei index, indicating left ventricular diastolic dysfunction in IDMs, were detected (LV e' p = 0.016; LV a' p = 0.003; LV e'/ a' p = 0.000; LV Tei index p = 0.023). IDMs’ cord serum IGF-1 levels were found weakly correlated with the interventricular septum (IVS) and left ventricle posterior wall (LVPW) thicknesses in M-Mode and LV e' and LV e'/a' in TDI (IVS r = 0.357, p = 0.008; LVPW r = 0.289, p = 0.034; LV e' r = 0.297, p = 0.029; LV e'/ a' r = 0.031, p = 0.014).

Conclusion: To our knowledge, this is the first study to examine the relationship between cord serum IGF-1 levels and diastolic functions of IDMs assessed by TDI. A weak correlation was found between IGF-1 levels and IVS and LVPW thicknesses in M-Mode and LV e' and LV e'/a' parameters in TDI, revealing diastolic dysfunction in IDMs.

What is Known:

• The umbilical cord blood serum IGF-1 level of IDMs is higher than in infants of healthy mothers.

• Diastolic dysfunction is a well-studied and frequently observed consequence in IDMs.

What is New:

• This is the first study to examine the relationship between cord serum IGF-1 levels and diastolic functions of IDMs assessed by TDI.

• A weak correlation was detected between the median cord serum IGF-1 level of IDMs and the median values of IVS, LVPW, LV e', LV a', LV e'/a' ratio.

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Abbreviations

AGA:

Appropriate for gestational age

DM:

Diabetes mellitus

EF:

Ejection fraction

FS:

Fractional shortening

GDM:

Gestational diabetes mellitus

HCM:

Hypertrophic cardiomyopathy

IDM:

Infants of diabetic mother

IGF-1:

Insulin-like growth factor-1

IVS:

Interventricular septum thickness

LV:

Left ventricle

LVED:

Left ventricular end-diastolic diameter

LVES:

Left ventricular end-systolic diameters

LVPW:

Left ventricular posterior wall thickness

NICU:

Neonatal intensive care unit

RV:

Right ventricle

TDI:

Tissue Doppler echocardiography

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Acknowledgements

We thank all the parents and babies who participated in the study.

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Authors and Affiliations

  1. Department of Pediatrics, Zeynep Kamil Maternity and Children’s Diseases Training and Research Hospital, Istanbul, Turkey

    Zeynep Ergenc, Nil Yazar Alpay & Abdülkadir Bozaykut

  2. Division of Pediatric Cardiology, Department of Pediatrics, Zeynep Kamil Maternity and Children’s Diseases Training and Research Hospital, Istanbul, Turkey

    Taner Yavuz

Authors
  1. Zeynep Ergenc
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  2. Taner Yavuz
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  4. Abdülkadir Bozaykut
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Contributions

Zeynep Ergenc contributed to the conception, design, supervision, funding, materials, data collection, processing, analysis, literature review, and writing of the article. Taner Yavuz contributed to the article’s conception, design, supervision, materials, data collection, and analysis. Nil Yazar Alpay contributed to the conception, design, supervision, data collection, and literature review. Abdülkadir Bozaykut contributed to the conception, design, supervision, interpretation, and critical review.

Corresponding author

Correspondence to Zeynep Ergenc.

Ethics declarations

Ethics approval, consent to participate, and consent for publication

Approval for the study was obtained from the Ethics Committee of Zeynep Kamil Maternity and Children’s Diseases Training and Research Hospital (approval number: 051, approval date: 05/02/2016). Written consent was obtained from all parents who agreed to participate in and be published.

Conflict of interest

The authors declare no competing interests.

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Communicated by Daniele De Luca.

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Ergenc, Z., Yavuz, T., Alpay, N.Y. et al. Umbilical cord serum insulin-like growth factor-1 levels of infants of diabetic mothers are correlated with diastolic dysfunction detected by tissue Doppler echocardiography. Eur J Pediatr 182, 1281–1288 (2023). https://doi.org/10.1007/s00431-022-04792-2

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