Department of Pediatrics, Lund University, 221 85 Lund, Sweden.
Pediatr Res. 2011 May;69(5 Pt 1):448-53. doi: 10.1203/PDR.0b013e3182115000.
Pronounced growth restriction (GR) occurs after very preterm birth. The interaction between IGF-I, nutritional intake, and growth was evaluated prospectively in 64 infants with a mean (SD) GA of 25.7 (1.9) wk. Blood sampling of IGF-I and measurements of weight, length, and head circumference were performed weekly until discharge. Daily calculation of nutritional intake was performed. Standard deviation scores (SDSs) for growth parameters defined two growth phases: GR phase (birth until lowest SDS) and catch-up (CU) phase (lowest SDS until 35 gestational weeks). IGF-I concentrations during the first postnatal weeks were low and increased at 30 wk GA, irrespective of GA at birth, coinciding with initiation of CU growth. Concentrations of IGF-I were positively associated with change in weight SDS during the GR phase, p = 0.001 and CU phase, p = 0.004-0.027. Protein and energy intake were not associated with change in SDS weight during the GR phase as opposed to the CU phase (p < 0.001, respectively). Nutritional intake did not correlate to concentrations of IGF-I before 30 wk GA. IGF-I is associated with growth at an earlier postnatal age than nutrient intake and the effect of nutrition on levels of IGF-I may be restricted to the period of established CU growth.
严重早产儿出生后会出现明显的生长受限（GR）。本研究前瞻性评估了 64 例平均（SD）胎龄为 25.7（1.9）周的婴儿的 IGF-I、营养摄入和生长之间的相互作用。每周对 IGF-I 进行采血，并测量体重、身长和头围，直至出院。每日计算营养摄入量。生长参数的标准差评分（SDS）将生长阶段定义为：GR 阶段（出生至最低 SDS）和追赶生长（CU）阶段（最低 SDS 至 35 孕周）。出生后第一周 IGF-I 浓度较低，在 30 周 GA 时增加，与 CU 生长开始的时间无关，与 GA 无关。IGF-I 浓度与 GR 阶段（p = 0.001）和 CU 阶段（p = 0.004-0.027）体重 SDS 的变化呈正相关。在 GR 阶段，与 CU 阶段相比（分别为 p < 0.001），蛋白质和能量摄入与 SDS 体重的变化无关。在 30 周 GA 之前，营养摄入与 IGF-I 浓度无关。IGF-I 与出生后更早的生长有关，而与营养摄入无关，营养对 IGF-I 水平的影响可能仅限于建立 CU 生长的时期。
