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Diabetes Care. 2019 May;42(5):964-971. doi: 10.2337/dc18-2041. Epub 2019 Mar 4.

Placental 11β-HSD2 and Cardiometabolic Health Indicators in Infancy.

Author information

1
Department of Obstetrics and Gynecology, Lunenfeld-Tanenbaum Research Institute, Prosserman Center for Population Health Research, Mount Sinai Hospital, and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
2
Sainte-Justine University Hospital and Research Center, University of Montreal, Montreal, Quebec, Canada.
3
Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
4
Department of Pathology, Charles-Lemoyne Hospital, Longueuil, Quebec, Canada.
5
Department of Obstetrics and Gynecology, Lunenfeld-Tanenbaum Research Institute, Prosserman Center for Population Health Research, Mount Sinai Hospital, and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada zcluo@lunenfeld.ca anne-monique.nuyt@recherche-ste-justine.qc.ca.
6
Obstetrics and Gynecology, University of Sherbrooke, Sherbrooke, Quebec, Canada.
7
Sainte-Justine University Hospital and Research Center, University of Montreal, Montreal, Quebec, Canada zcluo@lunenfeld.ca anne-monique.nuyt@recherche-ste-justine.qc.ca.

Abstract

OBJECTIVE:

Fetal excessive exposure to glucocorticoids may program cardiometabolic risk. Placental 11 β-hydroxysteroid dehydrogenase 2 (11β-HSD2) serves as a barrier to prevent fetal overexposure to maternal glucocorticoids. It has not been explored whether placental 11β-HSD2 levels are associated with cardiometabolic health in postnatal life.

RESEARCH DESIGN AND METHODS:

In a prospective birth cohort study of 246 mother-infant pairs, we measured placental 11β-HSD2 expression and maternal (32-35 weeks of gestation) and cord plasma cortisol concentrations. The primary outcomes were HOMA of insulin resistance (IR) and blood pressure (BP) in infants at age 1 year. Other outcomes included fasting insulin, HOMA β-cell function, carotid intima-media thickness, weight z score, and skinfold thickness (triceps and subscapular) at age 1 year.

RESULTS:

Placental 11β-HSD2 expression was negatively correlated with HOMA-IR (r = -0.17, P = 0.021) and fasting insulin (r = -0.18, P = 0.017) and marginally negatively correlated with systolic BP (r = -0.16, P = 0.057) but was not correlated with HOMA of β-cell function, diastolic BP, carotid intima-media thickness, and skinfold thickness (all P > 0.1) in infants at age 1 year. Cord plasma cortisol was negatively correlated to skinfold thickness (r = -0.20, P = 0007) but was not correlated with other outcomes at age 1 year. Maternal plasma cortisol was positively correlated with maximal carotid intima-media thickness (r = 0.20, P = 0.03) but was not correlated with other outcomes. Adjusting for maternal and infant characteristics, the associations were similar.

CONCLUSIONS:

The study is the first to show that higher placental 11β-HSD2 expression is associated with lower IR in infancy. Independent cohort studies are required to confirm this novel finding.

PMID:
30833369
DOI:
10.2337/dc18-2041

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