胎龄、性别和时间会影响极早产儿尿液生物标志物的浓度。
Gestational age, sex, and time affect urine biomarker concentrations in extremely low gestational age neonates.
机构信息
Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA.
Department of Biostatistics, University of Washington, Seattle, WA, USA.
出版信息
Pediatr Res. 2022 Jul;92(1):151-167. doi: 10.1038/s41390-021-01814-x. Epub 2021 Nov 30.
BACKGROUND
Our understanding of the normative concentrations of urine biomarkers in premature neonates is limited.
METHODS
We evaluated urine from 750 extremely low gestational age (GA) neonates without severe acute kidney injury (AKI) to determine how GA affects ten different urine biomarkers at birth and over the first 30 postnatal days. Then, we investigated if the urine biomarkers changed over time at 27, 30, and 34 weeks postmenstrual age (PMA). Next, we evaluated the impact of sex on urine biomarker concentrations at birth and over time. Finally, we evaluated if urine biomarkers were impacted by treatment with erythropoietin (Epo).
RESULTS
We found that all ten biomarker concentrations differ at birth by GA and that some urine biomarker concentrations increase, while others decrease over time. At 27 weeks PMA, 7/10 urine biomarkers differed by GA. By 30 weeks PMA, 5/10 differed, and by 34 weeks PMA, only osteopontin differed by GA. About half of the biomarker concentrations differed by sex, and 4/10 showed different rates of change over time between males vs. females. We found no differences in urine biomarkers by treatment group.
CONCLUSIONS
The temporal patterns, GA, and sex differences need to be considered in urine AKI biomarker analyses.
IMPACT
Urine biomarker concentrations differ by GA at birth. Some urine biomarkers increase, while others decrease, over the first 30 postnatal days. Most urine biomarkers differ by GA at 27 weeks PMA, but are similar by 34 weeks PMA. Some urine biomarkers vary by sex in premature neonates. Urine biomarkers did not differ between neonates randomized to placebo vs. Epo.
背景
我们对早产儿尿液生物标志物的正常浓度的了解有限。
方法
我们评估了 750 名极低胎龄（GA）且无严重急性肾损伤（AKI）的新生儿的尿液，以确定 GA 如何在出生时以及出生后前 30 天影响十种不同的尿液生物标志物。然后，我们研究了这些生物标志物在孕龄（PMA）后 27、30 和 34 周时是否随时间而变化。接下来，我们评估了性别对出生时和随时间尿液生物标志物浓度的影响。最后，我们评估了红细胞生成素（Epo）治疗是否会影响尿液生物标志物浓度。
结果
我们发现，所有十种生物标志物浓度在出生时均因 GA 而不同，而且一些尿液生物标志物的浓度随着时间的推移而增加，而另一些则减少。在 27 周 PMA 时，有 7/10 的尿液生物标志物因 GA 而不同。到 30 周 PMA 时，有 5/10 不同，到 34 周 PMA 时，只有骨桥蛋白因 GA 而不同。大约一半的生物标志物浓度因性别而异，并且有 4/10 的生物标志物在男性和女性之间的变化率不同。我们未发现尿液生物标志物因治疗组而异。
结论
在尿液 AKI 生物标志物分析中，需要考虑时间模式、GA 和性别差异。
影响
尿液生物标志物在出生时因 GA 而不同。出生后前 30 天，一些尿液生物标志物增加，而另一些则减少。大多数尿液生物标志物在 27 周 PMA 时因 GA 而不同，但在 34 周 PMA 时相似。在早产儿中，一些尿液生物标志物因性别而异。接受安慰剂与 Epo 随机分组的新生儿之间，尿液生物标志物无差异。
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