The Course Of IGF-1 Levels and Nutrient Intake in Extremely and Very Preterm Infants During Hospitalisation

Abstract

Background: Insulin-like growth factor 1 (IGF-1) plays an important role in the complex association between nutrition, growth, and maturation in extremely and very preterm infants. Nevertheless, in this population, research on associations between IGF-1 and nutrition is limited. Therefore this study aimed to evaluate the possible associations between the course of IGF-1 levels and nutrient intake between preterm birth and 36 weeks postmenstrual age (PMA). Methods: 87 infants born between 24 and 32 weeks gestational age were followed up to 36 weeks PMA. Actual daily macronutrient intake was calculated, and growth was assessed weekly. IGF-1 was sampled from umbilical cord blood at birth and every other week thereafter. Results: There was an inverse relationship between the amount of parenteral nutrition in the second week of life and IGF-1. Total protein, fat, and carbohydrate intake, as well as total energy intake, primarily showed a positive association with IGF-1 levels, particularly between 30 and 33 weeks PMA. Gestational age, bronchopulmonary dysplasia (BPD), and weight were significant confounders in the association between nutrient intake and IGF-1 levels. Conclusion: Parenteral nutrition was found to be a negative predictor of IGF-1 levels, and there could potentially be a time frame in which macronutrient intake is unable to impact IGF-1 levels. Future research should aim to narrow down this time frame and to gain more insight into factors enhancing or decreasing the response of IGF-1 to nutrition, e.g., age and inflammatory state, to align nutritional interventions accordingly.

Nutritional Intake, White Matter Integrity, and Neurodevelopment in Extremely Preterm Born Infants

“…In fact, 25% of myelin consists of protein [37]. Additionally, protein intake in preterm infants is positively associated with levels of insulin-like growth factor 1 (IGF-1) [38][39][40]. IGF-1 stimulates protein synthesis, glucose uptake, and cell development [33].…”

“…In contrast to parenteral protein intake, enteral protein intake influences the gastrointestinal tract. This may reduce inflammation by elevation of IGF-1 levels [40,43,44] and by communication with the microbiome-gut-brain axis, contributing to white matter development [15,45]. However, the effect of parenteral protein intake on brain development may be confounded by illness, since the sickest infants receive parenteral nutrition for the longest time and are most vulnerable to brain injury.…”

Metabolic Hormone Profiles in Breast Milk From Mothers of Moderate-Late Preterm Infants Are Associated With Growth From Birth to 4 Months in a Sex-Specific Manner

“…IGF-1 supplementation has been proposed to improve these conditions. However, there remain a lack of data around the possible impact of IGF-1 on preterm infants in the long term (65,66). Similar to our previous findings in the STEPS Finnish cohort, the results of the present study seem to suggest that increased IGF-1 in HM, and specifically during early lactation, may favor a beneficial effect in relation to body composition during early life and better metabolic outcomes in the longer term (e.g., lower BMI, lower weight gain, increased fat-free mass).…”

Early Nutrition during Hospitalization in Relation to Bone Health in Preterm Infants at Term Age and Six Months Corrected Age

“…After birth, total parenteral feeding was administered and minimal enteral feeding was started as described previously [ 25 ]. During total parenteral feeding, the infants had an energy intake of 85–100 kcal kg −1 day −1 , a fat intake of 3–3.5 g kg −1 day −1 , and a protein intake of 3–4 g kg −1 day −1 .…”