Cord blood insulin, IGF-I, IGF-II, leptin, adiponectin and ghrelin, and their associations with insulin sensitivity, β-cell function and adiposity in infancy

Diabet Med. 2018 Oct;35(10):1412-1419. doi: 10.1111/dme.13671. Epub 2018 May 31.


Aim: Vulnerability to insulin resistance and Type 2 diabetes may originate in early life, but little is known about whether any perinatal biomarkers are predictive of later metabolic health. We sought to assess whether cord blood insulin, insulin-like growth factor (IGF)-I, IGF-II, leptin, adiponectin and ghrelin are associated with metabolic health indicators in infancy.

Methods: In a prospective singleton birth cohort, we assessed cord blood insulin, IGF-I, IGF-II, leptin, adiponectin and ghrelin concentrations in relation to the homeostasis model assessment of insulin resistance (HOMA-IR), β-cell function (HOMA-β), fasting proinsulin-to-insulin ratio, BMIz-score, and the sum of triceps and subscapular skinfold thickness (an indicator of adiposity) in infants at age 1 year (n = 185).

Results: Adjusting for maternal and infant characteristics, one standard deviation (sd) increase in cord blood adiponectin was associated with an 11.1% (95% confidence interval 1.8-19.5%) decrease in HOMA-β (P = 0.02) and a 13.6% (1.8-26.8%) increase in proinsulin-to-insulin ratio (P = 0.02), indicating worse β-cell function in infants at age 1 year. One sd increase in cord blood insulin was associated with a 0.5 (0.1-1.0) mm increase in skinfold thickness (P = 0.01). One sd increase in cord blood ghrelin was associated with a 0.2 (0.02-0.3) decrease in BMIz-score (P = 0.02) and a 0.5 (0.1-0.9) mm decrease (P = 0.02) in skinfold thickness. Cord blood IGF-I and IGF-II were not associated with the observed metabolic health indicators at age 1 year.

Conclusion: The study is the first to show that cord blood adiponectin may be negatively predictive of β-cell function, whereas cord blood ghrelin may be negatively predictive of adiposity in infancy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adiponectin / blood
  • Adiposity / physiology*
  • Adult
  • Biomarkers / blood*
  • Child Development / physiology*
  • Cohort Studies
  • Female
  • Fetal Blood / chemistry
  • Fetal Blood / metabolism*
  • Ghrelin / blood
  • Humans
  • Infant
  • Infant, Newborn
  • Insulin / blood
  • Insulin Resistance / physiology*
  • Insulin-Like Growth Factor I / analysis
  • Insulin-Like Growth Factor I / metabolism
  • Insulin-Like Growth Factor II / analysis
  • Insulin-Like Growth Factor II / metabolism
  • Insulin-Secreting Cells / physiology*
  • Leptin / blood
  • Male
  • Pregnancy
  • Pregnancy Trimester, Third / blood
  • Prenatal Exposure Delayed Effects / blood
  • Prenatal Exposure Delayed Effects / physiopathology
  • Skinfold Thickness


  • ADIPOQ protein, human
  • Adiponectin
  • Biomarkers
  • Ghrelin
  • IGF1 protein, human
  • IGF2 protein, human
  • Insulin
  • Leptin
  • Insulin-Like Growth Factor I
  • Insulin-Like Growth Factor II