Neonatal IGF‐1/IGFBP‐1 axis and retinopathy of prematurity are associated with increased blood pressure in preterm children

Abstract

AimPreterm children are at risk of developing increased blood pressure (BP). We evaluated possible associations between BP, early insulin-like growth factor-1 (IGF-1) and IGF-binding protein-1 (IGFBP-1) levels and retinopathy of prematurity (ROP) in preterm children.MethodsThe study included 32 infants: median gestational age 28.1 weeks (range 24.6–31.3) and birthweight standard deviation scores (SDS) (±SD) 1.0 ± 2.7. IGF-1 and IGFBP-1 at postnatal weeks 32.6–34.6 and ROP stages were established after birth. BP was measured at the age of 4 years. The ratio (IGF-1)2/IGFBP-1 was created to investigate the influence of both IGF-1 and IGFBP-1 to later BP.ResultsDiastolic BP correlated with IGFBP-1, inversely correlated with IGF-1 and IGF-12/IGFBP-1 (r = −0.71, p < 0.0001) and positively correlated with catch-up growth velocity from lowest weight SDS to age 36.5 weeks (r = 0.48, p < 0.01), independent of gestational age. Children with moderate-to-severe ROP as neonates had higher mean arterial BP [78 (±95%CI 74–83) vs 71 (±95%CI 68–75) mm Hg, p < 0.05] adjusted for gestational age and birthweight SDS compared to children diagnosed with no to mild ROP.ConclusionLow neonatal IGF-12/IGFBP-1 and severe ROP were associated with higher BP in 4-year-old children born very preterm and may thus predict future cardiovascular morbidity.

Systemic arterial hypertension but not IGF-I treatment stimulates cardiomyocyte enlargement in neonatal lambs

“…Insulin-like growth factor I (IGF-I) causes fetal cardiomyocyte proliferation without increasing maturation (45) and is therefore a candidate for therapeutic manipulation of cardiomyocyte number in the immature heart. To our knowledge, the action of IGF-I on neonatal cardiomyocytes in large mammals has not been studied, although IGF-I is a treatment for retinopathy of prematurity (25).…”

Retinopathy of Prematurity Is Associated with Increased Systolic Blood Pressure in Adults Who Were Born Preterm

“…This is in accordance with BP findings in another group of preterm children with severe ROP. At the age of 4 years, these infants presented with higher mean office arterial pressure [2]. In a large retrospective meta-analysis, however, ROP was not associated with increased BP in ex-preterm subjects [10].…”

“…Immaturity and being born small for gestational age (GA) [1] are proposed to explain this association. Neonatal complications such as retinopathy of prematurity (ROP) [2] have also been associated with hypertension in children who were born preterm.…”

¿Qué se conoce sobre el futuro de la madre y el niño en el parto prematuro?

“…Los factores metabólicos tendrían relación con este hallazgo. En un estudio de niños de 28 semanas de nacidos muy pretérmino, los niveles bajos de la relación factor 1 de crecimiento simil a insulina-1 (IGF-1)/ proteína 1 ligadora de IGF (IGFBP-1) neonatales y la retinopatía de prematuridad se asociaron a presión arterial más elevada a los 4 años de edad en comparación con niños sin retinopatía, morbilidad que podría indicar la posibilidad de enfermedad cardiovascular futura (34) .…”