The role of insulin-like growth factor-1 (IGF-1) in the regulation of growth of children with intrauterine growth is currently being discussed, but the final point of view has not been achieved.
Aim: to study the effect of IGF-1 in the dynamics of postnatal growth of premature infants with SGA in the first 5 years of life.
Material and Methods: The prospective study included prematurity with SGA (group 1, n=100) and prematurity corresponding to gestational age (group 2, n=69). Anthropometric (body length/height) and hormonal parameters (IGF-1) were evaluated at birth, at 1 year and at 5 years. Serum concentrations of IGF-1 were determined by immunochemiluminescence analysis. Statistical analysis was performed using the Mann-Whitney criterion of Spearman criterion.
Results: Premature infants with SGA naturally had lower body length at birth. Indicators of body length of prematurity in group 1 correspond 40.0 [35.5; 44.0] cm, in group 2 43.0 [40.5; 47.0] (P<0.05). In subsequent periods of follow-up, premature infants with SGA retained lower body length/height values: in 1 year - 71.5 [70.0; 73.4] cm (in group 2 - 75.0 [72.6; 76.0] cm, P<0.05), in 5 years - 104.5 [99.5; 108.5] cm (in group 2 - 108.0 [104.0; 110.5] cm, P<0.05). The concentration of IGF-1 less than 25.0 ng/ml in the neonatal period was observed in all examined groups 1. In group 2, the level of IGF-1 less than 25 ng/ml was registered in 25.0% of children, in 75.0% - there were fluctuations in the range of 27.1-78.0 ng/ml. Subsequently, the IGF-1 median was significantly lower in group 1. At the age of 1 year, IGF-1 values in group 1 were 63.3 [45.3; 77.8] ng/ml, in group 2 - 81.3 [66.3; 99.4] ng/ml (P<0.05); at the age of 5 years - 92.3 [56.9; 105.6] ng/ml and 134.0 [82.1; 168.0] ng/ml, respectively (P<0.05). The lowest values of IGF-1 were recorded in children of group 1 with severe growth retardation (less than -2.0 SD): in 1 year 45.2 [41.3; 47.3] ng/ml (P<0.05), in 5 years 43.0 [32.7; 49.7] ng/ml (P<0.05). Correlation analysis proved the relationship between growth retardation and the level of IGF-1 in the group of prematurely born with SGA: in 1 year r=0.72 (P<0.05), in 5 years r=0.74 (P<0.05).
Summary: Insulin-like growth factor-1 in the first 5 years of life is one of the growth regulators of prematurity with SGA.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology