Glycation of fetal hemoglobin reflects hyperglycemia exposure in utero

Abstract

OBJECTIVE The lifetime risk of metabolic diseases in offspring of women with gestational diabetes mellitus (GDM) depends, at least in part, on the impact of glycemic fetal programming. To quantify this impact, we have developed and validated a unique mass spectrometry method to measure the percentage of glycated hemoglobin in cord blood. RESEARCH DESIGN AND METHODS This case-control study includes 37 GDM women and 30 pregnant women with normal glucose tolerance (NGT). RESULTS Glycation of the a-chain (Gla) was higher in neonates from GDM (2.32 vs. 2.20%, P < 0.01). Gla strongly correlated with maternal A1C measured at delivery in the overall cohort (r = 0.67, P < 0.0001) as well as in each group (GDM: r = 0.66, P< 0.0001; NGT: r = 0.50, P = 0.01). CONCLUSIONS Thus, Gla may reflect hyperglycemic exposure during the last weeks of fetal development. Future studies will confirm Gla is a predictive biomarker of prenatally programmed lifetime metabolic health and disease.