Restricted postnatal growth is reflected by low serum adiponectin levels during the second phase of ROP

Abstract

 

Purpose

 

To identify physiologic response patterns explaining ROP development in infants born very preterm. Generally adiponectin (APN) production is up-regulated by weight loss and down regulated by weight gain, oxidative stress as well as pro-inflammatory cytokines. Disturbed homeostasis, impaired growth and inflammation are factors closely related to ROP development. This study assessed the longitudinal development and correlation of growth with serum adiponectin levels and ROP development in very preterm infants.

 

Methods

 

A descriptive cohort study of 46 infants with gestational age (GA) < 29 weeks with a mean (SD) gestational age at birth of 25.9 (1.6) weeks and mean (SD) birth weight of 842 (237) g with weekly blood sampling of APN. Weight was recorded at birth and thereafter weekly until discharge. Weight standard deviation scores (WSDS) were obtained from Scandinavian reference growth curves. ROP was determined according to the International ROP classification. Mean weight, weight SDS total APN were calculated for three intervals (PNA-1) corresponding to a postnatal age from birth up to < 4 weeks and (PNA-2) from PNA 4 weeks up to PNA <8 weeks and PNA-3 from PNA 8 weeks up to PNA 12 weeks.

 

Results

 

Nineteen infants developed ROP. No difference in cord blood APN was found between infants with no ROP and infants with any ROP adjusting for GA at birth. Infants who developed ROP had significantly lower WSDS at all PNA weeks. Mean levels of APN was higher in infants with no ROP compared to those with any ROP during PNA week 1-3 also after adjusting for GA at birth. During period PNA-2 APN levels did not differ between infants who developed ROP and infants with no ROP. In period PNA-3 mean APN levels were again significantly higher in infants with no ROP as compared to infants with any ROP also after adjusting for GA at birth.

 

Conclusions

 

Adiponectin levels exhibit an interesting response pattern with a rapid increase during the first weeks after birth followed by a decrease and then a plateau of persistent lower APN levels in infants developing ROP at a time point corresponding to the second phase of ROP.

 

 

Weekly development for longitudinal serum adiponectin levels (left bottom) and weight SDS (right top) for infants with no ROP (solid line) and any ROP (dotted line)

 

Keywords: 706 retinopathy of prematurity • 467 clinical laboratory testing