Iranian Journal of Pediatrics
Tehran University of Medical Sciences Press
Vol. 23, No. 4, 2013, pp. 403-410
Bioline Code: pe13078
Full paper language: English
Document type: Research Article
Document available free of charge
Iranian Journal of Pediatrics, Vol. 23, No. 4, 2013, pp. 403-410
© Iranian Journal of Pediatrics
Early Aggressive Parenteral Nutrition Induced High Insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP3) Levels Can Prevent Risk of Retinopathy of Prematurity|
Can, Emrah; Bülbül, Ali; Uslu, Sinan; Bolat, Fatih; Cömert, Serdar & Nuhoğlu, Asiye
Objective: To evaluate early aggressive vs. conservative nutrition and its effect on Retinopathy of Prematurity
(ROP) in <32 weeks of gestation neonates.
Methods: A prospective, randomized, clinical study was conducted in NICU with a total of 75 preterm infants.
In the intervention group, infants received early aggressive nutrition immediately after birth, in the control
group infants were started on conventional parenteral nutrition (PN). Blood samples were obtained for
Insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP3) levels before
commencement of PN on the first postnatal day, and from week 1 to 6 every week. All the infants were
examined for ROP.
Findings: Infants in the early aggressive group had a reduction in the risk of ROP of 5% (2 from 40); the
number of infants needed treatment averaged 3.7 (2.7 to 5.2). A total of 11 neonates in the conventional
group were detected having ROP (P<0.05). Overall, IGF-I levels were higher in the aggressive PN (APN) vs the
conventional PN (CPN). ROP development was higher in the CPN compared to the APN. IGF-1levels were
lower in ROP developers compared with non-ROP in the APN group. There was no difference in IGF-I levels in
ROP developers versus non-ROP in the CPN group. IGF-1 levels were lower in the CPN group compared with
the APN group in the third week in ROP developers. There was a correlation between ROP and IGF-1 levels.
Through ROC analysis, IGF-1 was demonstrated as being a sensitive marker for ROP.
Conclusion: IGF-1 levels were higher in the APN group versus the CPN group. This may indicate that IGF-1
levels simply being higher is not enough; rather, that being higher above a cutoff value may prevent ROP.
Parenteral nutrition; Prematurity; Retinopathy of prematurity; IGF-1; IGFBP3
Alternative site location: http://diglib.tums.ac.ir/pub/