Impact of Decreased Serum Insulin-Like Growth Factor-1 Levels on Central Aortic Compliance in Small-for-Gestational-Age Infants

Abstract

Background: Intrauterine growth restriction is associated with arterial hypertension in adulthood; however, the underlying mechanism is unclear. Objectives: We hypothesized that serum insulin-like growth factor-1 (IGF-1) levels affect central aortic elastic properties and structure in small-for-gestational-age (SGA) infants. Methods: Eighteen SGA infants and 22 appropriate-for-gestational-age (AGA) infants were enrolled in this study. The serum IGF-1 level within 1 h of birth and abdominal aortic echo parameters at 1 week of age were retrospectively compared. Results: In the SGA infants, IGF-1 levels (27.6 ± 17.7 vs. 42.6 ± 15 ng/ml, p = 0.006), aortic strain (10.2 ± 3.1 vs. 12.8 ± 3.1%, p = 0.01), and aortic distensibility (0.73 ± 0.19 vs. 0.92 ± 0.34 cm²/dyn × 10^-4, p = 0.05) were significantly lower compared with AGA infants. By contrast, blood pressure, aortic intima-media thickness (aIMT) in relation to body weight (383 ± 163 vs. 256 ± 43 μm/kg, p < 0.001), aortic stiffness index in relation to body weight (2.0 ± 1.7 vs. 1.1 ± 0.4, p = 0.005), and arterial pressure-strain elastic modulus (293 ± 72 vs. 242 ± 78 mm Hg, p = 0.04) were higher compared with AGA infants. In the SGA infants, IGF-1 levels were significantly correlated with aortic strain (r = 0.49, p = 0.04), aIMT in relation to body weight (r = -0.61, p = 0.007), and aortic stiffness index in relation to body weight (r = -0.63, p = 0.005). Conclusions: Decreased serum IGF-1 levels in SGA infants may affect the vascular compliance and structure of the central aorta.

What is the evidence for beneficial effects of growth hormone treatment beyond height in short children born small for gestational age? A review of published literature

“…As many of these alterations are subclinical and may not be evident in very young children [46], the long-term effect of these changes in adult life remain to be determined. Compared with their AGA peers, infants born SGA (n = 18-22) may display significantly impaired central aortic compliance (aortic strain, aortic distensibility, p = 0.05) [47], while older children may have significantly impaired endothelial function [48]. Significantly raised levels of interleukin-6 [49], triglycerides and apolipoprotein-B/apolipoprotein-A1 ratio have also been identified in neonates born SGA compared with those born AGA [50].…”

Cardiac and placental mitochondrial characterization in a rabbit model of intrauterine growth restriction

“…Placenta is crucial in fetal programming in that, for example, changes in the pattern of the substrates or oxygen transported to the fetus can ultimately lead to cardiovascular or metabolic disease (5)(6)(7). Indeed, it is well known that IUGR is associated with cardiovascular remodeling and dysfunction, persisting into adulthood (8)(9)(10)(11). Establishing the molecular mechanisms of cardiovascular remodeling in IUGR newborns is hampered by the difficulty of accessing the heart as a target tissue.…”

Impact of perinatal factors on biomarkers of cardiovascular disease risk in preadolescent children

“…Aortic stiffness or stiffness index was measured in 10 studies ( n = 40–90) [41,42,46,47,51,53,57–60]. Participants were 1 h to 10 years old and ranged from extremely preterm to term.…”

“…In the studies exploring aIMT in relation to LBW/SGA/ FGR in this review, different gestational ages were included and different definitions of LBW/SGA/FGR were used [41][42][43][44][45][46][47][48]. Key to unpicking the interplay of 'smallness', placental insufficiency and gestational age will be to establish consistent definitions of LBW, SGA and FGR.…”

“…All six studies investigating aIMT found higher measurements in LBW/SGA/FGR groups compared to AGA controls [41][42][43][44][45][46][47][48]. The reported aIMT differences in the articles by Akawaza et al (2016 and 2017) [41,42] and Koklu et al (2006 and [44,45] are considered as reports of the same study (exploring different associations with aIMT) due to overlapping authorship, recruitment periods, and similarity of study population demographics. Sample size ranged from 40 to 80 participants, gestational age at birth from very preterm to term, and age from 1 h to 18 months.…”