Relationship between Insulin-Like Growth Factor I Levels, Early Insulin Treatment, and Clinical Outcomes of Very Low Birth Weight Infants

被引:26
作者
Beardsall, Kathryn [1 ,2 ]
Vanhaesebrouck, Sophie [3 ]
Frystyk, Jan [4 ,5 ]
Ogilvy-Stuart, Amanda L. [2 ]
Vanhole, Christine [3 ]
van Weissenbruch, Mirjam [6 ]
Midgley, Paula [7 ]
Thio, Marta [8 ]
Cornette, Luc
Gill, Bryan [9 ]
Ossuetta, Iviano [10 ]
Iglesias, Isabel [8 ]
Theyskens, Claire [11 ]
de Jong, Miranda [6 ]
Ahluwalia, Jag S. [2 ]
de Zegher, Francis [3 ]
Dunger, David B. [1 ]
机构
[1] Univ Cambridge, Addenbrookes Hosp NHS Trust, Dept Pediat, Cambridge CB2 0QQ, England
[2] Cambridge Univ Hosp NHS Fdn Trust, Neonatal Unit, Cambridge, England
[3] Univ Louvain, Dept Woman & Child, Louvain, Belgium
[4] Aarhus Univ Hosp, Fac Hlth, Dept Clin Med, Med Res Lab, DK-8000 Aarhus, Denmark
[5] Aarhus Univ Hosp, Dept Internal Endocrinol & Internal Med, DK-8000 Aarhus, Denmark
[6] Vrije Univ Amsterdam Med Ctr, Amsterdam, Netherlands
[7] Royal Infirm Edinburgh NHS Trust, Simpson Ctr Reprod Hlth, Edinburgh, Midlothian, Scotland
[8] Hosp Univ St Joan Deu, Barcelona, Spain
[9] Leeds Gen Infirm, Leeds, W Yorkshire, England
[10] Luton & Dunstable Hosp, Luton, Beds, England
[11] ZOL Genk, Genk, Belgium
关键词
IGF-I; SOMATOTROPIC AXIS; RETINOPATHY; PREMATURE; THERAPY; CELLS;
D O I
10.1016/j.jpeds.2013.12.046
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objectives Insulin regulates the secretion of insulin-like growth factor I (IGF-I) in the newborn, and low levels of IGF-I have been linked to neonatal morbidity. As part of the Neonatal Insulin Replacement Therapy in Europe Trial, we investigated the impact of early insulin treatment on IGF-I levels and their relationship with morbidity and growth. Study design Prospective cohort analyses of data collected as part of an international randomized controlled trial. Blood samples (days 1, 3, 7, and 28), were taken for IGF-I bioassay from 283 very low birth weight infants (<1500 g). Results Early insulin treatment led to a late increase in IGF-I levels between day 7 and 28 (P = .028). In the first week of life IGF-I levels were lower in infants with early hyperglycemia; mean difference -0.10 mu g/L (95% CI -0.19, -0.02, P = .02). Lower levels of IGF-I at day 28 were independently associated with an increased risk of chronic lung disease, OR 3.23 (95% CI, 1.09-9.10), and greater IGF-I levels were independently associated with better weight gain, 0.10 kg (95% CI, 0.03-0.33, P = .02). Conclusions Early intervention with insulin is related to increased IGF-I levels at 28 days. Low IGF-I levels are associated with hyperglycemia, increased morbidity, and reduced growth. Increasing IGF-I levels may improve outcomes of very low birth weight infants.
引用
收藏
页码:1038 / +
页数:8
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