Abstract
Purpose :
Premature infants can develop several complications including ROP and hyperglycemia. Hyperglycemia is usually associated with morbidity and mortality including other complications. We hypothesize that the glucose metabolism which is regulated by the hypoxia inducible factor -1α (HIF-1α) and hyperglycemia plays an important role in the development of ROP.
Methods :
This study is approved by the Texas Tech University Health Sciences Center (TTUHSC) IRB. The plasma samples were obtained from the clinical lab of hospital. Twenty-seven infants were included in this study, 14 were born at gestational age (GA) less than 32 weeks (high risk for ROP) and 13 were born at more than 32 GA (low risk for ROP). The blood glucose levels were collected from the medical record. Glycolytic products pyruvate and lactate were measured using colorimetric assays kits. HIF-1α and VEGF levels were measured by their respective Human ELISA Assay Kits. The data was analyzed using GraphPad Prism 8 Software. Plasma levels of these factors at 33 PMA were compared between high and low risk groups by student t and f test. Statistical significance was set <0.05.
Results :
The glucose levels were higher in high risk for ROP group (less than 32 weeks GA) compared to low risk infants (29 weeks 110.7 ±4.13, 30 weeks 89.21 ±4.67, 32 weeks 82.90±2.56, 38 weeks 65.36 ±1.81, and 40 weeks 66.02 ±1.54 mg/dL, comparisons between 29,30, and 32 vs 40 p<0.0001 and comparison between 38 vs 40 weeks p=0.77). At 33 weeks PMA, there were no significant differences in VEGF ( 588.2±199.0 vs 229.7±445.0, pg/mL, p=0.46), HIF-1α ( 1862.8 ± 782.6 vs 1910.8 ±1237.4, pg/mL, p=0.90), blood glucose levels ( 82.5 ± 7.8 vs 66.2 ± 5.5, mg/dL, p=0.089), and lactate levels ( 8.6 ± 0.6 vs 8.4 ± 1.2, mM, p=0.89), respectively for high risk and low risk infants. The pyruvate level in high risk infants was significantly higher than in low risk infants ( 13.2 ±2.1 vs 0.4 ±4.3, nmol, p=0.007).
Conclusions :
Low gestational age infants at high risk for ROP have hyperglycemia from birth. The high levels of pyruvate are directly associated to the high rate of glucose metabolism. The pathophysiology mechanism of ROP remains to be established and due to the hypoxic environment caused by the disease development. Our data suggests that glucose metabolism plays an important in the development of ROP.
This is a 2020 ARVO Annual Meeting abstract.