Amsterdam UMC, Department of Pediatrics, VU University Medical Center, 1081 HV Amsterdam, The Netherlands.
Nutrients. 2020 Mar 2;12(3):675. doi: 10.3390/nu12030675.
Insulin-like growth factor 1 (IGF-1) plays an important role in the complex association between nutrition, growth, and maturation in extremely and very preterm infants. Nevertheless, in this population, research on associations between IGF-1 and nutrition is limited. Therefore this study aimed to evaluate the possible associations between the course of IGF-1 levels and nutrient intake between preterm birth and 36 weeks postmenstrual age (PMA).
87 infants born between 24 and 32 weeks gestational age were followed up to 36 weeks PMA. Actual daily macronutrient intake was calculated, and growth was assessed weekly. IGF-1 was sampled from umbilical cord blood at birth and every other week thereafter.
There was an inverse relationship between the amount of parenteral nutrition in the second week of life and IGF-1. Total protein, fat, and carbohydrate intake, as well as total energy intake, primarily showed a positive association with IGF-1 levels, particularly between 30 and 33 weeks PMA. Gestational age, bronchopulmonary dysplasia (BPD), and weight were significant confounders in the association between nutrient intake and IGF-1 levels.
Parenteral nutrition was found to be a negative predictor of IGF-1 levels, and there could potentially be a time frame in which macronutrient intake is unable to impact IGF-1 levels. Future research should aim to narrow down this time frame and to gain more insight into factors enhancing or decreasing the response of IGF-1 to nutrition, e.g., age and inflammatory state, to align nutritional interventions accordingly.
胰岛素样生长因子 1（IGF-1）在极早产儿和超早产儿的营养、生长和成熟的复杂关联中起着重要作用。然而，在这一人群中，关于 IGF-1 与营养之间关联的研究有限。因此，本研究旨在评估 IGF-1 水平的变化与早产儿出生至 36 周校正胎龄（PMA）期间营养摄入之间的可能关联。
87 名胎龄在 24 至 32 周之间的婴儿被随访至 36 周 PMA。计算实际的每日宏量营养素摄入量，并每周评估生长情况。在出生时和此后每隔一周从脐血中抽取 IGF-1 样本。
生命的第二周接受的肠外营养量与 IGF-1 呈负相关。总蛋白、脂肪和碳水化合物的摄入量以及总能量的摄入量主要与 IGF-1 水平呈正相关，特别是在 30 至 33 周 PMA 之间。胎龄、支气管肺发育不良（BPD）和体重是营养摄入与 IGF-1 水平之间关联的显著混杂因素。
肠外营养被发现是 IGF-1 水平的负预测因子，并且可能存在一个时间段，在此期间，宏量营养素的摄入无法影响 IGF-1 水平。未来的研究应旨在缩小这一时间范围，并深入了解增强或降低 IGF-1 对营养反应的因素，例如年龄和炎症状态，以相应地调整营养干预措施。
