Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Aug;23(4):403-10.

Early Aggressive Parenteral Nutrition Induced High Insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP3) Levels Can Prevent Risk of Retinopathy of Prematurity

Emrah Can  1 , Ali Bülbül  1 , Sinan Uslu  1 , Fatih Bolat  1 , Serdar Cömert  1 , Asiye Nuhoğlu  1
Affiliations

Early Aggressive Parenteral Nutrition Induced High Insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP3) Levels Can Prevent Risk of Retinopathy of Prematurity

Emrah Can et al. Iran J Pediatr. 2013 Aug.

Abstract

Objective: To evaluate early aggressive vs. conservative nutrition and its effect on Retinopathy of Prematurity (ROP) in <32 weeks of gestation neonates.

Methods: A prospective, randomized, clinical study was conducted in NICU with a total of 75 preterm infants. In the intervention group, infants received early aggressive nutrition immediately after birth, in the control group infants were started on conventional parenteral nutrition (PN). Blood samples were obtained for Insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP3) levels before commencement of PN on the first postnatal day, and from week 1 to 6 every week. All the infants were examined for ROP.

Findings: Infants in the early aggressive group had a reduction in the risk of ROP of 5% (2 from 40); the number of infants needed treatment averaged 3.7 (2.7 to 5.2). A total of 11 neonates in the conventional group were detected having ROP (P<0.05). Overall, IGF-I levels were higher in the aggressive PN (APN) vs the conventional PN (CPN). ROP development was higher in the CPN compared to the APN. IGF-1levels were lower in ROP developers compared with non-ROP in the APN group. There was no difference in IGF-I levels in ROP developers versus non-ROP in the CPN group. IGF-1 levels were lower in the CPN group compared with the APN group in the third week in ROP developers. There was a correlation between ROP and IGF-1 levels. Through ROC analysis, IGF-1 was demonstrated as being a sensitive marker for ROP.

Conclusion: IGF-1 levels were higher in the APN group versus the CPN group. This may indicate that IGF-1 levels simply being higher is not enough; rather, that being higher above a cutoff value may prevent ROP.

Keywords: IGF-1; IGFBP3; Parenteral nutrition; Prematurity; Retinopathy of prematurity.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Flow diagram of eligible newborns. The number of neonates not randomized and the reasons for non-enrolment are provided. APN: Aggressive Parenteral Nutrition; CPN: Conventional Parenteral Nutrition
Fig. 2
Fig. 2
Left: Cut-off point level 30 ng/ml for IGF-1 (sensitivity 100%, specificity 87.5%) Right: Cut-off point level 1300 ng/ml for IGFBP3 (sensitivity 90%, specificity 90%) IGF-1: Insulin-like growth factor 1
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Hagadorn JI, Richardson DK, Schmid CH, et al. Cumulative illness severity and progression from moderate to severe retinopathy of prematurity. J Perinatol. 2007;27(8):502–9. - PubMed
    1. Bang P, Westgren M, Schwander J, et al. Ontogeny of insulin-like growth factor-binding protein-1, -2, and -3: quantitative measurements by radioimmuno-assay in human fetal serum. Pediatr Res. 1994;36(4):528–36. - PubMed
    1. D'Ercole AJ, Willson DF, Underwood LE. Changes in the circulating form of serum somatomedin-C during fetal life. J Clin Endocrinol Metab. 1980;51(3):674–6. - PubMed
    1. Langford K, Nicolaides K, Miell JP. Maternal and fetal insulin-like growth factors and their binding proteins in the second and third trimesters of human pregnancy. Hum Reprod. 1998;13(5):89–93. - PubMed
    1. Hellstrom A, Carlsson B, Niklasson A, et al. IGF-I is critical for normal vascularization of the human retina. J Clin Endocrinol Metab. 2002;87(7):3413–6. - PubMed

LinkOut - more resources