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C. A. Lofqvist, G. Hellgren, A. Niklasson, E. Engstrom, A.-L. Hard, I. Hansen-Pupp, D. Ley, L. E. Smith, A. Hellstrom; The Role of Early Liver Function for Igf-i Synthesis and Later Rop Development. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5226.
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AFP is a critical serum transport protein produced by the liver during embryogenesis and can be used as a marker for liver development. During development fetal AFP starts to drop in early third trimester. Insulin-like growth factors (IGFs) are mainly synthesized by more mature hepatocytes. Our previous research has established that lack of IGF-I is one of the most important factors for the development of ROP. We have shown both in mice and in children that low levels of serum IGF-I are strongly associated with reduced vessel survival. Thus, the aim of this study was to explore if poor liver development reflected in activity AFP levels was associated with, circulating IGF-I levels as well as ROP development.
Eighty-six infants (39 boys) born at the university clinics in Gothenburg and Lund 2000-2007 with a gestational age (GA) of 26.4 weeks (range 23.0 - 29.6) and a birth weight (BW) of 857 g (range 348 -1540) were included in the present study where weekly serum samples of IGF-I from birth to 36 postmenstrual (PMA) weeks and serum AFP levels at birth were evaluated along with the development of ROP.
There was an association between AFP at birth and mean serum IGF-I at PMA 30-33 weeks (when induction of ROP occurs). A multiple regression model including AFP serum levels at birth, birth weight standard deviation score (SDS), GA and gender explained mean serum levels of IGF-I at PMA 30-33 weeks, R2=0.324, p<0.001. Preliminary multinomial logistic regression analysis suggests that there is an association for GA, BW and AFP at birth with later development of threshold ROP and that this association is stronger for girls.
We found that AFP, possibly reflecting liver development, explained postnatal serum IGF-I levels. In the best fitted model explaining threshold ROP AFP was included. Thus the degree of early liver activity may be a factor responsible for later ROP development.
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