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IGF-I, Growth, and Body Composition in Preterm Infants up to Term Equivalent Age
Dana F J Yumani1, Harrie N Lafeber1, Mirjam M van Weissenbruch1
1Amsterdam UMC, VU University Medical Center, Department of Pediatrics, Amsterdam 1081 HV, the Netherlands.
Insights
Impaired early growth in preterm infants is linked to poorer body composition at term equivalent age. This impacts long-term cardiometabolic health, highlighting the importance of monitoring infant growth.
Area of Science:
- Neonatalogy
- Pediatric Endocrinology
- Growth and Development
Background:
- Concerns exist regarding higher early fat mass in preterm infants and later cardiometabolic risks.
- Understanding factors influencing preterm infant body composition is crucial for long-term health outcomes.
Purpose of the Study:
- To examine the relationship between Insulin-like Growth Factor-I (IGF-I) and growth patterns.
- To determine their role in shaping body composition of preterm infants by term equivalent age.
Main Methods:
- Observational study (August 2015 - August 2018) involving preterm infants (gestational age 24-32 weeks).
- Bi-weekly IGF-I measurements and weekly growth assessments from birth to term equivalent age.
- Body composition (fat mass, fat-free mass) assessed using air displacement plethysmography at term equivalent age.
Main Results:
- Increased IGF-I in the first month correlated with greater fat-free mass.
- Higher weight gain SDS in the first month was associated with increased fat-free mass percentage.
- Greater weight gain SDS up to term equivalent age was linked to a lower fat-free mass percentage.
Conclusions:
- Impaired early growth, particularly in the first month, is associated with less favorable body composition at term equivalent age.
- These findings underscore the significance of early growth trajectories for neonatal body composition and potential future health.
Context:
There are concerns that a higher fat mass in the early life of preterm infants is associated with adverse cardiometabolic outcomes in young adulthood.
Objective:
To investigate the role of IGF-I and growth in determining body composition of preterm infants at term equivalent age.
Methods:
An observational study was conducted from August 2015 to August 2018. From birth to term equivalent age, IGF-I levels were measured bi-weekly and growth was assessed weekly. At term equivalent age, body composition was assessed through air displacement plethysmography; 65 infants with a gestational age of 24 to 32 weeks were assessed at term equivalent age, of whom 58 completed body composition measurement. The main outcome measures were fat (free) mass (g) and fat (free) mass percentage at term equivalent age.
Results:
In the first month of life, each 0.1 nmol/L per week increase in IGF-I was associated with a 465 g (SE 125 g) increase in fat free mass. A greater increase in weight SDS in the first month of life was associated with a higher fat free mass percentage (B 200.9; 95% CI, 12.1-389.6). A higher head circumference SDS was associated with more fat free mass (r = 0.46; 95% CI, 0.21-0.65). However, a greater increase in weight SDS up to term equivalent age was associated with a lower fat free mass percentage (B -55.7, SE 9.4).
Conclusion:
These findings suggest that impaired growth in the first month of life is associated with a less favorable body composition at term equivalent age.
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