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POSTNATAL SERUM INSULIN-LIKE GROWTH FACTOR I AND RETINOPATHY OF PREMATURITY
Anne K Jensen1, Gui-Shuang Ying, Jiayan Huang
1*Division of Ophthalmology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and †Scheie Eye Institute, Department of Ophthalmology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
Insights
Low serum insulin-like growth factor 1 (IGF-1) levels are linked to severe retinopathy of prematurity (ROP) in a diverse U.S. infant cohort. This finding supports using IGF-1 for ROP screening.
Area of Science:
- Neonatal medicine
- Endocrinology
- Ophthalmology
Background:
- Low serum insulin-like growth factor 1 (IGF-1) is associated with severe retinopathy of prematurity (ROP).
- Previous studies on this association were primarily from European cohorts.
- No U.S.-based studies have investigated this relationship in a diverse population.
Purpose of the Study:
- To determine the relationship between postnatal serum IGF-1 levels and severe ROP.
- To examine this association in a racially diverse U.S. cohort of premature infants.
Main Methods:
- Prospective cohort study of 74 infants with birth weight <1,251 g across 3 Philadelphia hospitals.
- Weekly postnatal filter paper blood spot IGF-1 assays were performed up to 42 weeks postmenstrual age.
- ROP outcomes were monitored and correlated with IGF-1 levels, adjusting for birth weight and gestational age.
Main Results:
- The cohort comprised 20 white, 45 black, 2 Asian, and 9 other infants, with a median gestational age of 27.6 weeks.
- Lower mean IGF-1 levels were observed during postmenstrual age weeks 28-33 in infants with more severe ROP stages (Stage 3: 17.0 ng/mL, Stage 1-2: 18.0 ng/mL, No ROP: 20.0 ng/mL; P = 0.003).
- This association remained significant after adjusting for birth weight and gestational age.
Conclusions:
- A significant association exists between low postnatal serum IGF-1 and ROP in a racially diverse U.S. population.
- The findings are consistent with European cohorts, suggesting a universal pathophysiological link.
- This association supports the development of growth-based predictive models to enhance ROP screening efficiency.
Purpose:
Low serum IGF-1 has been associated with development of severe ROP, but no U.S. studies have been reported. We sought to determine the relationship between postnatal serum IGF-1 levels and severe ROP in a racially diverse U.S. cohort.
Methods:
Prospective cohort study of 74 infants with birth weight <1,251 g and a known ROP outcome at 3 Philadelphia hospitals. Weekly postnatal filter paper blood spot IGF-1 assays were measured through 42 weeks postmenstrual age.
Results:
The cohort included 20 white, 45 black, 2 Asian, and 9 other infants; median gestational age was 27.6 weeks (range 23-33 weeks), and median birth weight was 975 g (range 490-1,250 g). During postmenstrual age Weeks 28 to 33, mean IGF-1 was 20.0 ng/mL (standard error 0.52) for no ROP (n = 46), 18.0 (0.49) for Stage 1 or 2 (n = 23), and 17.0 (0.70) for Stage 3 (n = 5, 2 lasered) (P = 0.003). Adjustment for birth weight and gestational age showed similar results.
Conclusion:
The presence and timing of an association between low postnatal serum IGF and ROP in a racially diverse U.S. sample were found to be consistent with those of European cohorts. This association provides the pathophysiological basis for growth-based predictive models, which could improve efficiency of ROP screening.
