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Changes in Serum Insulin-Like Growth Factors, Not Leptin, Are Associated With Postnatal Weight Gain in Preterm Neonates

Hui-Chen Lo, PhD^*,, Lon-Yen Tsao, MD, Wen-Yin Hsu, MS, Chiu-Yen Chi, BS and Fu-Ann Tsai, BS

From the ^* Department of Bioscience Technology, Chang-Jung Christian University, Tainan, Taiwan; and the Department of Medical Education Research, Department of Pediatrics, and Team of Clinical Nutrition Support Service, Changhua Christian Hospital, Changhua, Taiwan

Correspondence: Lon-Yen Tsao, MD, Department of Pediatrics, Changhua Christian Hospital, 135 Nanhsiao Street, Changhua, 500, Taiwan. Electronic mail may be sent to 66161{at}cch.org.tw.

Background: Serum concentrations of conventional nutrition-related proteins, such as albumin, prealbumin, transferrin, and retinol-binding protein, are usually inconsistent with changes in anthropometric measurements in the postnatal period. The aim of this study was to evaluate how reliable growth hormone (GH), insulin-like growth factors (IGFs), IGF-binding proteins (IGFBPs), and leptin, the proteins known to be involved in the regulation of growth, are in reflecting postnatal growth and nutritional status in preterm neonates. Methods: Blood samples and anthropometric measurements were collected from 55 preterm neonates (chronological age 30.4 ± 2.8 weeks) for 4 continuous weeks (weeks 0 to 3). Results: After adjusting for chronological age, body weights and serum IGF-II concentrations were significantly greater and serum transferrin concentrations were significantly lower in weeks 2 and 3 than in week 0 (repeated-measures analysis of variance (ANOVA) and Bonferroni test, p < .05). Forward stepwise multivariate regression analysis showed that change in total IGF-I (week 0 to week 3) was a positive predictor, and changes in insulin and prealbumin were negative predictors of postnatal weight gain. In addition, daily fat intake was a positive predictor of postnatal length increases, and changes in prealbumin, insulin, and GH were negative predictors of postnatal changes in the ponderal index (weight x length^–3). Changes in GH and IGFBP-2 were negative predictors of changes in head circumference and triceps skinfold thickness, respectively. Conclusions: Serial measurements of serum IGF-I and IGF-II may be useful adjuncts to anthropometric measurements for monitoring postnatal growth and nutritional status in preterm neonates.

Journal of Parenteral and Enteral Nutrition, Vol. 29, No. 2, 87-92 (2005)
DOI: 10.1177/014860710502900287


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