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Published on: June 24, 2020
Early Elevation in Interleukin-6 is Associated with Reduced Growth in Extremely Low Birth Weight Infants
Lee A Denson1, Scott A McDonald2, Abhik Das2
1Department of Pediatrics, Gastroenterology, Hepatology, and Nutrition, Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, Cincinnati, Ohio.
Insights
Elevated interleukin-6 (IL-6) in the first month of life is linked to reduced growth velocity (GV) in extremely low birth weight infants. This suggests IL-6 may directly impact postnatal growth and energy balance.
Area of Science:
- Neonatal research
- Pediatric growth studies
- Inflammatory marker analysis
Background:
- Extremely low birth weight (ELBW) infants face challenges in achieving optimal growth.
- Inflammatory processes are implicated in various neonatal morbidities and growth impairments.
- Understanding early markers of growth restriction is crucial for timely intervention.
Purpose of the Study:
- To investigate the association between early inflammatory cytokine levels and growth velocity (GV) in ELBW infants.
- To determine if elevated cytokines precede reduced postnatal growth.
- To explore the role of interleukin-6 (IL-6) in growth restriction.
Main Methods:
- Studied 768 infants with birth weights between 401 and 1,000 grams.
- Measured blood cytokines up to day 21 and determined growth velocity at 36 weeks' postmenstrual age (PMA).
- Utilized linear regression models, adjusting for factors like late-onset sepsis (LOS), birth weight (BW), and energy intake.
Main Results:
- Interleukin-6 (IL-6) levels were elevated at days 14 and 21 in infants with LOS.
- Higher IL-6 levels at days 14 and 21 were significantly associated with reduced weight-GV at 36 weeks' PMA (p < 0.0001).
- The association between IL-6 and weight-GV was influenced by BW and energy intake, and not solely explained by LOS.
Conclusions:
- Elevated IL-6 during the first month of life is a predictor of lower weight-GV in ELBW infants at 36 weeks' PMA.
- IL-6 may directly influence postnatal growth by affecting energy balance.
- Early IL-6 monitoring could identify infants at risk for growth restriction.
Abstract:
Objective To determine whether reduced growth velocity (GV) in extremely low birth weight infants is preceded by elevated inflammatory cytokines. Study Design GV was determined at 36 weeks' postmenstrual age (PMA) in 768 infants 401 to 1,000 g birth weight (BW). Association between blood cytokines measured through day of life 21 and GV was explored using linear regression models that adjusted for late-onset sepsis (LOS), BW, small for gestational age (SGA), gender, race, energy intake, and center. Results Serum interleukin-6 (IL-6) was increased at days 14 and 21 in LOS infants. LOS was associated with reduced energy intake and GV for weight (weight-GV) at 36 weeks' PMA. Linear regression analysis controlling for LOS and energy intake showed significant relationships between increased IL-6 at days 14 and 21 with reduced weight-GV at 36 weeks' PMA (p < 0.0001). The relationship between day 21 IL-6 and weight-GV was not associated with LOS (p = 0.12) when controlling for BW and energy intake. Both BW (p = 0.02) and energy intake (p = 0.003) influenced the relationship between day 14 IL-6 and weight-GV. Conclusion IL-6 elevation during the first month of life is associated with lower weight-GV at 36 weeks' PMA and may have a direct effect upon energy balance and postnatal growth.
