Growth hormone binding protein and maternal body mass index in relation to placental growth hormone and insulin requirements during pregnancy in type 1 diabetic women

Physiology and pathophysiology of growth hormone-binding protein: Methodological and clinical aspects

“…Placental GH is reported to correlate inversely to GHBP levels [203]. The relationship between GHBP and BMI is maintained during pregnancy, although the significance is less pronounced [169,170,202].…”

“…This GH variant binds to the high-affinity GHBP with the same binding properties as the pituitary GH [64]. The levels of GHBP gradually increase during pregnancy to reach a maximum in the second trimester, followed by a decline to normal levels before term [72,170,172,202]. Placental GH is reported to correlate inversely to GHBP levels [203].…”

Aspects of placental growth hormone physiology

“…The liver may be the predominant source, however, adipose tissue appears to be important for GHBP levels [21], wherefore the maternal increase in weight and fat mass during pregnancy may be of importance. Maternal serum GHBP correlates to BMI during pregnancy, though it appears that this association is lost in late pregnancy where BMI not only reflects the maternal fat mass but also the increasing size of the pregnancy product [148,149]. Any contribution to circulating GHBP from placental GHRs remains speculative.…”

“…In the course of pregnancy, serum GHBP levels follow a bell-shaped curve. Increasing levels are seen in the first half of pregnancy, then a decline is observed [140,[148][149][150][151]. The impact of diabetes on GHBP levels is recognised in pregnancy as well with lower GHBP levels in type 1 diabetic pregnancies, but the bell-shaped course through-out pregnancy still exists [140,148,149].…”

Factors determining insulin requirements in women with type 1 diabetes mellitus during pregnancy: a review

“…Although insulin requirements also decreased there was no correlation with hPGH, IGF-I, IGF-II levels or GH binding protein. 49,96 However, the study was insufficiently powered to detect this relationship. Secondly, Nielsen et al 97 showed that women with T1DM during pregnancy have lower IGF-1 and higher hPGH levels compared with healthy women.…”