Validating impact of temporal changes of adiponectin in relation to ROP development

Abstract

Purpose : To validate earlier found physiologic response patterns explaining retinopathy of prematurity (ROP) development in infants born very preterm. Generally adiponectin 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 postnatal development of serum adiponectin levels and ROP development in a new cohort of very preterm infants.

Methods : A study was performed in 90 infants with gestational age (GA) < 28 weeks with a mean (SD) gestational age at birth of 25.2 (1.4) weeks and mean (SD) birth weight of 882 (220) g. Cord blood samples and thereafter venous blood samples were obtained at postnatal day 1, 7, 14, 28 days and at postmenstrual age 32, 36 and 40 weeks. Serum adiponectin levels were assayed using a human adiponectin ELISA kit (E091M, Mediagnost, Germany). The intra-assay CVs were 3.8% at 3.9 µg/mL and 4.7% at 13.1 µg/mL and the inter-assay CV was 16.3% at 9.9 µg/mL. ROP was determined according to the International ROP classification.

Results : Thirteen infants died before completing 40 weeks. ROP stages were assessed in 77 infants and grouped as ROP stage 0 (n=16), ROP stage 1 (n=11), ROP stage 2 (n=20) and ROP stage 3 (n=30). The temporal pattern showed that mean adiponectin concentrations increased steeply during the first 14 days after birth from 2.7 ± 3.7 (mean ± SD) µg/mL at day 1 to 47.3 ± 25.6 µg/mL at 14 days (P < 0.001). From 28 days after birth to 32 weeks postmenstrual age mean adiponectin levels gradually decreased.Mean adiponectin levels were consistently significantly lower in infants who developed proliferative ROP compared to infants with no ROP from birth up to postmenstrual age 32 weeks. During postmenstrual weeks 36 to 40 weeks mean adiponectin gradually increased to levels comparable to levels seen at 14 days after birth. Interestingly no significant difference in mean adiponectin levels were seen between ROP stages at this period.

Conclusions : Serum adiponectin levels exhibit an interesting biphasic response pattern in very preterm infants with a rapid increase during the first weeks after birth followed by a decrease and then a new increase. Persistent lower adiponectin levels were found in infants developing ROP at a time point preceeding ROP development.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.