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Measurement of cord insulin and insulin related peptides suggests females are more insulin resistant than males at birth

¹Diabetes Research, Peninsula Medical School, Exeter, UK
²Maternity Unit, Heavitree Hospital, Royal Devon and Exeter NHS Trust, Exeter, UK
³Research and Development Support Unit, Royal Devon and Exeter NHS Trust, Exeter, UK
⁴The Regional Endocrine Laboratory, University Hospital Birmingham NHS Trust, Birmingham, UK

Penelope.Clark{at}uhb.nhs.uk

ABSTRACT

Objective:We aimed to examine gender differences in insulin and insulin propeptide concentrations at birth using validated cord blood collection.

Research Design and Methods:1) We tested the impact on insulin and insulin propeptides of taking 13 cord blood samples in heparin and EDTA and then centrifuging and separating plasma after 1, 2, 24, or 48 hours at room temperature (heparin) or 4°C, (EDTA). 2) Cord plasma insulin and insulin propeptides concentrations were measured in 440 babies and correlated with offspring anthropometry measured at birth.

Results:1) Cord insulin concentrations significantly decreased (74% baseline by 24 hours, p=0.01) in the samples taken in heparin and stored at room temperature, but those taken on EDTA and refrigerated remained stable for up to 48 hours. Insulin propeptides were stable in both. 2) Cord plasma insulin and insulin propeptides measured in EDTA were related to all measures of birth size and maternal glycaemia and BMI (r>0.11,p<0.03 for all) and were higher in those delivered via Caesarean section. Females were lighter (3497 v 3608g, p=0.01) but had higher cord insulin (46.7 v 41.2 pmol/l, p=0.031), total proinsulin (34.1 v 25.8 pmol/l,p<0.001), and intact proinsulin (9.5 v 8.3 pmol/l,p=0.004) concentrations than males, a difference further confirmed when comparing girls and boys cord insulin when they were pair-matched for birth weight (insulin: 49.7 v 42.1 pmol/L, p=0.004).

Conclusion:When using appropriate sample collection methods, females have higher insulin concentrations than males at birth, despite being smaller, suggesting intrinsic insulin resistance in females.

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