利用血浆胰岛素样生长因子1（IGF1）、肿瘤坏死因子-α（TNF-α）水平及新生儿参数预测早产儿视网膜病变风险
Predicting Retinopathy of Prematurity Risk Using Plasma Levels of Insulin-like Growth Factor 1 (IGF1), Tumor Necrosis Factor-Alpha (TNF-Alpha), and Neonatal Parameters.
作者信息
Cioboata Daniela Mariana, Costescu Oana Cristina, Manea Aniko Maria, Doandes Florina Marinela, Zaharie Mihaela, Popa Zoran Laurentiu, Costescu Sergiu, Stoica Florina, Boia Marioara
机构信息
Department of Neonatology, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania.
Doctoral School Department, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania.
出版信息
Clin Pract. 2024 Aug 1;14(4):1515-1528. doi: 10.3390/clinpract14040122.
BACKGROUND/OBJECTIVES: Retinopathy of Prematurity (ROP) remains a leading cause of vision impairment in premature infants, especially those with Respiratory Distress Syndrome (RDS) necessitating respiratory support. This study aimed to identify correlations between plasma levels of Insulin-like Growth Factor 1 (IGF1) and Tumor Necrosis Factor-alpha (TNF-alpha), and the risk of developing ROP. Additionally, it explored the association of ROP severity grades with plasma levels of glucose, lactate dehydrogenase (LDH), creatin phosphokinase (CPK), and other biomarkers, aiming to uncover predictive markers for ROP risk and severity in this population.
METHODS
This prospective study included premature neonates admitted with RDS requiring respiratory support, conducted over 18 months at the Neonatal Intensive Care Unit of the Louis Turcanu Emergency Clinical Hospital for Children, Timisoara. Plasma levels of IGF1 and TNF-alpha were measured on days 1 and 14 post-birth, alongside the initial assessment of glucose, LDH, and CPK levels.
RESULTS
Significant correlations were observed between lower gestational age and elevated LDH levels on day 7-10 (rho = -0.341, = 0.0123) and between TNF-alpha levels at 2 weeks and ROP severity (rho = 0.512, = 0.0004). Elevated IGF1 levels were protective against ROP, with Beta coefficients of 0.37 ( = 0.0032) for the first collection and 0.32 ( = 0.0028) for the second, suggesting their potential as biomarkers for ROP risk assessment. Higher levels of TNF-alpha at 2 weeks were associated with an increased risk of ROP (Beta = -0.45, = 0.0014), whereas higher IGF1 levels offered protective effects against ROP, with Beta coefficients of 0.37 ( = 0.0032) for the first collection and 0.32 ( = 0.0028) for the second. Elevated LDH levels on day 7-10 post-birth were linked to an increased risk of ROP (Beta = 0.29, = 0.0214).
CONCLUSIONS
These findings highlight the potential of IGF1 and TNF-alpha as predictive biomarkers for ROP, offering avenues for early intervention and improved management strategies in this high-risk group.
背景/目的：早产儿视网膜病变（ROP）仍然是早产儿视力损害的主要原因，尤其是那些患有呼吸窘迫综合征（RDS）需要呼吸支持的婴儿。本研究旨在确定胰岛素样生长因子1（IGF1）和肿瘤坏死因子-α（TNF-α）的血浆水平与发生ROP风险之间的相关性。此外，还探讨了ROP严重程度分级与血浆葡萄糖、乳酸脱氢酶（LDH）、肌酸磷酸激酶（CPK）及其他生物标志物水平之间的关联，旨在揭示该人群ROP风险和严重程度的预测标志物。
方法
这项前瞻性研究纳入了因RDS需要呼吸支持而入院的早产儿，在蒂米什瓦拉的路易·图尔卡努儿童急诊临床医院新生儿重症监护病房进行了18个月。在出生后第1天和第14天测量IGF1和TNF-α的血浆水平，同时对葡萄糖、LDH和CPK水平进行初始评估。
结果
观察到胎龄较低与出生后第7 - 10天LDH水平升高之间存在显著相关性（rho = -0.341，P = 0.0123），以及2周时TNF-α水平与ROP严重程度之间存在显著相关性（rho = 0.512，P = 0.0004）。IGF1水平升高对ROP具有保护作用，首次采集时的β系数为0.37（P = 0.0032），第二次采集时为0.32（P = 0.0028），表明它们有潜力作为ROP风险评估的生物标志物。2周时较高的TNF-α水平与ROP风险增加相关（β = -0.45，P = 0.0014），而较高的IGF1水平对ROP具有保护作用，首次采集时的β系数为0.37（P = 0.0032），第二次采集时为0.32（P = 0.0028）。出生后第7 - 10天LDH水平升高与ROP风险增加相关（β = 0.29，P = 0.0214）。
结论
这些发现突出了IGF1和TNF-α作为ROP预测生物标志物的潜力，为这一高危群体的早期干预和改进管理策略提供了途径。
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