Cord serum dipeptidyl-peptidase 4 activity in gestational diabetes

Zahra Al-Aissa, Klára Rosta, Orsolya Hadarits, Jürgen Harreiter, András Zóka, Dagmar Bancher-Todesca, Attila Patócs, Katalin Kiss, Beatrix Sármán, Péter Pusztai, István Sziller, János Rigó, Károly Rácz, Anikó Somogyi, Alexandra Kautzky-Willer, Gábor Firneisz

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Background: Tissue-specific dipeptidyl-peptidase 4 (DPP4) dysregulation has been described in adults with diabetes mellitus. The DPP4 -incretin system has not been studied in foetal life. In this study, DPP4 activity and glucagon-like peptide-1 (GLP-1) levels were assessed in cord blood of neonates born to women with gestational diabetes mellitus (GDM) and nondiabetic controls. Material and methods: This study has been conducted in two Hungarian and one Austrian centres. Patients: A total of 568 pregnant women were enrolled in the study after their OGTT between the 24th and 28th gestational week. Cord blood samplings with DPP4 activity and GLP-1 level measurements were possible in 270 (DPP4: 159 control, 111 GDM) and 112 (GLP-1: 72 control, 40 GDM) cases. OGTT (24-28th gestational week) and cord blood sampling at delivery were performed. Cord serum DPP4 activity was determined in a continuous monitoring microplate-based kinetic assay, and cord plasma GLP-1 was measured using a fluorescence ELISA method. Results: Cord serum DPP4 activity was lower in GDM [mean (95% CI): 28·07 U/L (26·32-29·82 U/L)] than in controls [31·61 U/L (29·93-33·29 U/L), MWU P = 0·0015]. Cord plasma active GLP-1 levels were close to the lower detection limit and were not altered in GDM (control: mean = 3·43 pM, 95% CI: 3·04-3·82 pM, GDM: mean = 3·61 pM, 95% CI: 2·96-4·28 pM - MWU test P = 0·6). Conclusions: Decreased cord serum DPP4 activity in gestational diabetes mellitus might be the result of an adaptive foetal response or an early dysregulation in the entero-insular axis with consequences beyond the incretin system. Cord plasma GLP-1 levels may reflect the missing oral intake with a limited glucose sensing of L cells via the circulation in foetal life.

Original languageEnglish
Pages (from-to)196-203
Number of pages8
JournalEuropean Journal of Clinical Investigation
Issue number2
Publication statusPublished - Feb 1 2015


  • Cord blood
  • Dipeptidyl-peptidase 4 (DPP4)
  • Gestational diabetes mellitus (GDM)
  • Glucagon-like peptide-1 (GLP-1)
  • Pregnancy

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry

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    Al-Aissa, Z., Rosta, K., Hadarits, O., Harreiter, J., Zóka, A., Bancher-Todesca, D., Patócs, A., Kiss, K., Sármán, B., Pusztai, P., Sziller, I., Rigó, J., Rácz, K., Somogyi, A., Kautzky-Willer, A., & Firneisz, G. (2015). Cord serum dipeptidyl-peptidase 4 activity in gestational diabetes. European Journal of Clinical Investigation, 45(2), 196-203.