Background Infants of diabetic mothers (IDM) are at increased risk for metabolic complications. Type 1 and some type 2 diabetic patients have elevated levels of ketone bodies acetoacetate (AA) and β-hydroxybutyrate (BHB) in addition to hyperglycemia. The effect of ketonemia on the inflammatory markers in infants of diabetic mothers is unknown.
Objective The aim of this study is to examine how hyperketonemia in diabetic mothers affects markers of inflammation and oxidative stress in their offspring.
Methods Blood was obtained from 23 diabetic mothers and 13 healthy mothers, and their infants’ umbilical cords at the delivery. IL-8, MCP-1 and protein carbonyl (protein oxidation) levels were determined by ELISA. U937 human monocyte cell culture was used to examine the effect of AA and BHB on secretion of MCP-1.
Results There was a significant increase in the levels of AA in cord blood of diabetic mothers compared with cord blood of healthy mothers. A significant increase in the levels of protein oxidation (p<0.05) and MCP-1 levels (p<0.05) were observed in the cord blood of IDMs. The level of MCP-1 significantly correlated (r=0.51, p=0.01) with the concentration of AA in the IDM. In further experiments with cultured monocytes treated with exogenous AA (0–4 mM), a significant increase in MCP-1 secretion was observed with AA but not in BHB-treated monocytes.
Conclusion This study suggest that blood levels of AA, oxidative stress and MCP-1 are elevated in IDM, which may contribute to the development of the metabolic complications seen in IDM.