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Effects of protein intake on IGF1 and ROP

Divya Keerthy1,2, Angela Holuba3, David Bateman1

  • 1Morgan Stanley Children's Hospital, Columbia University, New York, NY, USA.

Journal of Neonatal-Perinatal Medicine
|June 23, 2025
PubMed

Insights

Higher protein in parenteral nutrition for premature infants increased insulin-like growth factor 1. This intervention was linked to a reduced risk of plus disease in retinopathy of prematurity, suggesting a potential benefit for vulnerable newborns.

Area of Science:

  • Neonatal nutrition
  • Pediatric ophthalmology
  • Endocrinology

Background:

  • Insulin-like growth factor 1 (IGF-1) plays a crucial role in neural and retinal development.
  • Optimizing IGF-1 levels may help prevent serious infant morbidities, such as retinopathy of prematurity.
  • Retinopathy of prematurity (ROP) is a significant concern in very low birth weight infants.

Purpose of the Study:

  • To investigate the impact of higher protein content in parenteral nutrition on IGF-1 levels in very low birth weight infants.
  • To determine the association between enhanced protein intake, IGF-1, and the incidence of retinopathy of prematurity.

Main Methods:

  • Post-hoc analysis of a prospective, double-blind, randomized controlled trial involving preterm infants (<1250g).
  • Infants were randomized to receive either high protein (4g/kg/d) or conventional protein (3g/kg/d) parenteral nutrition.
  • Weekly IGF-1 measurements and regular retinal examinations were conducted.

Main Results:

  • Infants in the high-protein group showed a significant 21.9% increase in IGF-1 levels (p=0.03).
  • While overall ROP and severe ROP were not significantly associated with protein intake or IGF-1, the high-protein group had a lower risk of plus disease (OR 0.17, p=0.02).
  • Infants with plus disease exhibited 25% lower mean IGF-1 levels (p=0.052).

Conclusions:

  • Higher protein administration in parenteral nutrition is associated with elevated IGF-1 levels in very low birth weight infants.
  • This nutritional strategy may reduce the risk of developing plus disease, a severe form of ROP.
  • Further research may elucidate the direct role of IGF-1 in mitigating ROP severity.

Keywords:
insulin-like growth factor 1plus diseaseprotein intakeretinopathy of prematurity

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