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Early Surge in Circulatory Adiponectin Is Associated With Improved Growth at Near Term in Very Preterm Infants
Ingrid Hansen-Pupp1, Gunnel Hellgren1, Anna-Lena Hård1
1Department of Pediatrics (I.H.P.), Institute of Clinical Sciences Lund, Lund University and Skane University Hospital, 221 85 Lund, Sweden; Department of Pediatrics, Institute of Clinical Sciences (G.H.), and Department of Ophthalmology, Institute of Neuroscience and Physiology (A.L.H., A.H., C.L.), The Sahlgrenska Academy at University of Gothenburg, 416 85 Gothenburg, Sweden; and Department of Ophthalmology (L.S.), Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115.
Insights
Early postnatal adiponectin levels in very preterm infants significantly increase within the first three weeks. Higher adiponectin concentrations correlate with improved infant growth, including weight and length.
Area of Science:
- Neonatal physiology
- Endocrinology
- Pediatric growth and development
Background:
- Adiponectin, a hormone, is known to enhance insulin sensitivity.
- Adiponectin may influence fetal and postnatal growth processes.
Purpose of the Study:
- To investigate the relationship between early postnatal changes in adiponectin concentration and subsequent growth in very preterm infants.
- To establish correlations between adiponectin levels and anthropometric measurements in this vulnerable population.
Main Methods:
- A prospective, longitudinal cohort study involving 52 very preterm infants (gestational age 26.0 ± 1.9 weeks).
- Adiponectin levels measured in cord blood and peripheral blood at multiple time points up to 40 weeks postmenstrual age (PMA).
- Weekly measurements of weight, length, and head circumference, with calculation of SD scores (SDS); daily energy and protein intake recorded.
Main Results:
- Mean adiponectin concentration significantly increased from 72 hours to 3 weeks post-birth.
- Early adiponectin levels (days 3-21) showed strong correlations with gestational age, birth weight, and birth weight SDS.
- Mean adiponectin during days 3-21 positively correlated with weight SDS, length SDS, and head circumference SDS at 35 weeks PMA.
Conclusions:
- Adiponectin concentrations rise substantially in the initial three weeks of life for very preterm infants.
- A more pronounced increase in adiponectin is associated with enhanced postnatal growth outcomes in this population.
Context:
Adiponectin enhances insulin sensitivity and may play a role in fetal and postnatal growth.
Objective:
This study aimed to determine whether early postnatal adiponectin concentration change is related to postnatal growth in very preterm infants.
Setting, Design, And Patients:
This was an in-hospital, prospective, longitudinal cohort study of 52 preterm infants with a gestational age (GA) of 26.0 ± 1.9 (SD) weeks and birth weight (BW) of 889 ± 284 g.
Interventions:
An analysis of adiponectin was performed on cord blood at birth and peripheral blood at 72 hours, day 7, and then weekly until postmenstrual age (PMA) 40 weeks. Weight, length, and head circumference (HC) measurement was performed weekly and SD scores (SDS) calculated. Energy and protein intake was calculated daily from birth until PMA 35 weeks.
Results:
Mean adiponectin concentration increased from 6.8 ± 4.4 μg/mL at 72 hours to 37.4 ± 22.2 μg/mL at 3 weeks; during days 3-21, it was 21.4 ± 12 μg/mL and correlated with GA at birth (r = 0.46, P = .001; BW: r = 0.71, P < .001; BW(SDS): r = 0.42, P = .003). Furthermore, mean adiponectin during days 3-21 correlated with weight(SDS), length(SDS), and HC(SDS) (r = 0.62, 0.65, and 0.62, respectively; all P < .001) at PMA 35 wk). Energy intake (kcal/kg/d) correlated with mean adiponectin during days 3-21 (r = 0.35, P < .013).
Conclusions:
In very preterm infants, adiponectin concentrations increased markedly in the first 3 weeks, and a greater increase was associated with improved postnatal growth.
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