Circulating diazepam‐binding inhibitor in infancy: Relation to markers of adiposity and metabolic health

Summary Background Diazepam‐binding inhibitor (DBI) controls feeding behaviour and glucose homeostasis. Individuals born small‐for‐gestational‐age (SGA) with excessive postnatal catch‐up in weight are at risk for obesity and type 2 diabetes. Objective To assess serum concentrations of DBI (0‐2 years) in appropriate‐for‐gestational‐age (AGA, n = 70) vs SGA infants (n = 33) with spontaneous catch‐up and their relationship with endocrine‐metabolic and adiposity markers. Methods Longitudinal assessments included auxology, fasting glucose, insulin, insulin‐like growth factor, high‐molecular‐weight adiponectin, DBI and body composition (absorptiometry). DBI was measured cross‐sectionally in pregnant and non‐pregnant women and in 2‐day‐old newborns. DBI mRNA expression levels were assessed in adult and neonatal tissues. Results Cord blood DBI concentrations were similar in AGA and SGA newborns and about fivefold higher than those in women. Serum DBI levels decreased by age 2 days, were higher in SGA vs AGA infants at age 2 years and associated negatively with markers of adiposity and insulin resistance and positively with high‐molecular‐weight adiponectin. DBI mRNA expression was lower in placenta than in other tissues. Conclusion The increased DBI concentrations at birth are unrelated to prenatal growth. The higher DBI levels in SGA subjects at age 2 years may be related to catch‐up growth or represent an adaptive mechanism to promote lipogenesis.