Paulpandian Rajarajan, Dutta Sourabh, Das Reena, Katoch Deeksha, Kumar Praveen
Neonatology Unit, Department of Pediatrics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
Department of Hematology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Pediatr. 2023 Nov;90(11):1089-1095. doi: 10.1007/s12098-023-04604-x. Epub 2023 May 25.
To determine whether red blood cell glucose-6-phosphate dehydrogenase (G6PD) activity is associated with retinopathy of prematurity (ROP).
This case-control study was conducted in a Level-3 neonatal unit. Subjects were inborn boys with birth weight <2000 g. "Cases" were consecutive subjects with ROP of any severity. "Controls" were consecutive unrelated subjects without ROP. Recipients of blood or exchange transfusions were excluded. Sixty cases (out of 98 screened) and 60 controls (out of 93 screened) were enrolled. G6PD activity (quantitative assay) as the candidate risk factor was evaluated.
Sixty cases with 60 controls [mean (SD) gestation 28.80 (2.2) and 30.60 (2.2) wk respectively] were compared. "Cases" had a higher median (1st, 3rd quartile) G6PD activity compared to "controls" [7.39 (4.7, 11.5) vs. 6.28 (4.2, 8.8) U/g Hb, p = 0.084]. G6PD activity was highest among ROP requiring treatment [8.68 (4.7, 12.3)] followed by ROP not requiring treatment [6.91 (4.4, 11.0)], followed by controls (p = 0.06). Gestation, birth weight, duration of oxygen, breastmilk feeding, and clinical sepsis were other variables associated with ROP on univariable analysis. On multivariable logistic regression, G6PD activity [Adjusted OR 1.14 (1.03, 1.25), p = 0.01] and gestation [Adjusted OR 0.74 (0.56, 0.97), p = 0.03] independently predicted ROP. C-statistic of the model was 0.76 (95% CI 0.67, 0.85).
Higher G6PD activity was independently associated with ROP after adjusting for confounders. Each 1 U/g Hb increase in G6PD increased the odds of ROP by 14%. Severer forms of ROP were associated with higher levels of G6PD activity.
确定红细胞葡萄糖-6-磷酸脱氢酶（G6PD）活性是否与早产儿视网膜病变（ROP）相关。
本病例对照研究在一家三级新生儿病房进行。研究对象为出生体重<2000g的男婴。“病例组”为患有任何严重程度ROP的连续入选对象。“对照组”为无ROP的连续非相关入选对象。排除接受输血或换血治疗的婴儿。共纳入60例病例（从98例筛查对象中选取）和60例对照（从93例筛查对象中选取）。对作为候选危险因素的G6PD活性（定量检测）进行评估。
对60例病例和60例对照[平均（标准差）孕周分别为28.80（2.2）和30.60（2.2）周]进行比较。与“对照组”相比，“病例组”的G6PD活性中位数（第1、第3四分位数）更高[7.39（4.7，11.5）对6.28（4.2，8.8）U/g血红蛋白，p = 0.084]。在需要治疗的ROP患儿中G6PD活性最高[8.68（4.7，12.3）]，其次是不需要治疗的ROP患儿[6.91（4.4，11.0）]，对照组最低（p = 0.06）。单因素分析显示，孕周、出生体重、吸氧时间、母乳喂养及临床败血症是与ROP相关的其他变量。多因素逻辑回归分析显示，G6PD活性[调整后比值比1.14（1.03，1.25），p = 0.01]和孕周[调整后比值比0.74（0.56，0.97），p = 0.03]可独立预测ROP。该模型的C统计量为0.76（95%置信区间0.67，0.85）。
校正混杂因素后，较高的G6PD活性与ROP独立相关。G6PD活性每增加1 U/g血红蛋白，ROP发生几率增加14%。更严重形式的ROP与更高水平的G6PD活性相关。
