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Medientyp:
E-Artikel
Titel:
Postnatal serum IGF-1 levels associate with brain volumes at term in extremely preterm infants
Beteiligte:
Hellström, William;
Hortensius, Lisa M.;
Löfqvist, Chatarina;
Hellgren, Gunnel;
Tataranno, Maria Luisa;
Ley, David;
Benders, Manon J.N.L.;
Hellström, Ann;
Björkman–Burtscher, Isabella M.;
Heckemann, Rolf A.;
Sävman, Karin
Erschienen:
Springer Science and Business Media LLC, 2023
Erschienen in:Pediatric Research
Sprache:
Englisch
DOI:
10.1038/s41390-022-02134-4
ISSN:
0031-3998;
1530-0447
Entstehung:
Anmerkungen:
Beschreibung:
<jats:title>Abstract</jats:title><jats:sec>
<jats:title>Background</jats:title>
<jats:p>Growth factors important for normal brain development are low in preterm infants. This study investigated the link between growth factors and preterm brain volumes at term.</jats:p>
</jats:sec><jats:sec>
<jats:title>Material/methods</jats:title>
<jats:p>Infants born <28 weeks gestational age (GA) were included. Endogenous levels of insulin-like growth factor (IGF)−1, brain-derived growth factor, vascular endothelial growth factor, and platelet-derived growth factor (expressed as area under the curve [AUC] for serum samples from postnatal days 1, 7, 14, and 28) were utilized in a multivariable linear regression model. Brain volumes were determined by magnetic resonance imaging (MRI) at term equivalent age.</jats:p>
</jats:sec><jats:sec>
<jats:title>Results</jats:title>
<jats:p>In total, 49 infants (median [range] GA 25.4 [22.9–27.9] weeks) were included following MRI segmentation quality assessment and AUC calculation. IGF-1 levels were independently positively associated with the total brain (<jats:italic>p</jats:italic> < 0.001, <jats:italic>β</jats:italic> = 0.90), white matter (<jats:italic>p</jats:italic> = 0.007, <jats:italic>β</jats:italic> = 0.33), cortical gray matter (<jats:italic>p</jats:italic> = 0.002, <jats:italic>β</jats:italic> = 0.43), deep gray matter (<jats:italic>p</jats:italic> = 0.008, <jats:italic>β</jats:italic> = 0.05), and cerebellar (<jats:italic>p</jats:italic> = 0.006, <jats:italic>β</jats:italic> = 0.08) volume adjusted for GA at birth and postmenstrual age at MRI. No associations were seen for other growth factors.</jats:p>
</jats:sec><jats:sec>
<jats:title>Conclusions</jats:title>
<jats:p>Endogenous exposure to IGF-1 during the first 4 weeks of life was associated with total and regional brain volumes at term. Optimizing levels of IGF-1 might improve brain growth in extremely preterm infants.</jats:p>
</jats:sec><jats:sec>
<jats:title>Impact</jats:title>
<jats:p><jats:list list-type="bullet">
<jats:list-item>
<jats:p>High serum levels of insulin-like growth factor (IGF)-1 during the first month of life were independently associated with increased total brain volume, white matter, gray matter, and cerebellar volume at term equivalent age in extremely preterm infants.</jats:p>
</jats:list-item>
<jats:list-item>
<jats:p>IGF-1 is a critical regulator of neurodevelopment and postnatal levels are low in preterm infants. The effects of IGF-1 levels on brain development in extremely preterm infants are not fully understood.</jats:p>
</jats:list-item>
<jats:list-item>
<jats:p>Optimizing levels of IGF-1 may benefit early brain growth in extremely preterm infants. The effects of systemically administered IGF-1/IGFBP3 in extremely preterm infants are now being investigated in a randomized controlled trial (Clinicaltrials.gov: NCT03253263).</jats:p>
</jats:list-item>
</jats:list></jats:p>
</jats:sec>