Postnatal Decrease in Circulating Insulin-Like Growth Factor-I and Low Brain Volumes in Very Preterm Infants

Abstract

Postnatal IGF-I and IGFBP-3 concentrations are positively associated with brain volumes at 40 GW in very preterm infants. Normalization of the IGF-I axis, directly or indirectly, may support normal brain development in very preterm infants.

Circulatory insulin-like growth factor-I and brain volumes in relation to neurodevelopmental outcome in very preterm infants

“…However, mean values of IGF-I differed between infants with subnormal vs. normal MDI after a PMA of 30 wk, i.e., during the phase of catchup growth. Similar temporal findings were observed when longitudinal mean IGF-I concentrations were related to differences in cerebellar volume (14). This implies that endogenous IGF-I concentrations during a defined period of catch-up growth may be of importance for brain growth, as well as later outcome.…”

“…We could not demonstrate any contribution of nutritional intake to later neurodevelopment in multivariate models. Previously, we were not able to show any correlation between nutritional intake and brain volumes in the same cohort of infants (14). Absence of significant relationships between nutritional intake and outcome may however be due to lack of sufficient statistical power.…”

“…The protocol for image acquisition and image processing has been described in detail previously (14).…”

“…We have previously shown that low postnatal IGF-I concentrations are related to decreased brain volumes at term age (14). As a consequence, we hypothesized that a lower rate of increase in IGF-I concentrations and lower brain volumes may be associated with impaired later neurodevelopment.…”

Dietary proteins and IGF I levels in preterm infants: determinants of growth, body composition, and neurodevelopment

“…Moreover, Hansen-Pupp et al found IGF I levels to correlate with brain volumes while there was no association with cerebral spinal fluid volume. The authors hypothesize that this could imply that IGF I does not limit atrophy secondary to brain damage, but rather stimulates brain growth (41). In premature infants, a higher rate of increase of IGF I until 35 wk postmenstrual age has directly been related to a better neurodevelopmental outcome at 2 y of age (39).…”