Elevated levels of IL-6 and IGFBP-1 predict low serum IGF-1 levels during continuous infusion of rhIGF-1/rhIGFBP-3 in extremely preterm infants.,Growth Hormone and IGF Research

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Elevated levels of IL-6 and IGFBP-1 predict low serum IGF-1 levels during continuous infusion of rhIGF-1/rhIGFBP-3 in extremely preterm infants.
Growth Hormone and IGF Research ( IF 1.4 ) Pub Date : 2019-11-09 , DOI: 10.1016/j.ghir.2019.11.001
Susanna Klevebro ₁ , Gunnel Hellgren ₂ , Ingrid Hansen-Pupp ₃ , Dirk Wackernagel ₁ , Boubou Hallberg ₁ , Jan Borg ₄ , Aldina Pivodic ₅ , Lois Smith ₆ , David Ley ₃ , Ann Hellström ₇

Affiliation

Objective

Steady state insulin-like growth factor-1 (IGF-1) levels vary significantly during continuous intravenous infusion of recombinant human insulin-like growth factor-1/recombinant human insulin-like growth factor binding protein-3 (rhIGF-1/rhIGFBP-3) in the first weeks of life in extremely preterm infants. We evaluated interleukin-6 (IL-6) and insulin-like growth factor binding protein-1 (IGFBP-1) levels as predictors of low IGF-1 levels.

Methods

Nineteen extremely preterm infants were enrolled in a trial, 9 received rhIGF-1/rhIGFBP-3 and 10 received standard neonatal care. Blood samples were analyzed daily for IGF-1, IL-6 and IGFBP-1 during intervention with rhIGF-1/rhIGFBP-3.

Results

Thirty seven percent of IGF-1 values during active treatment were <20 μg/L. Among treated infants, higher levels of IL-6, one and two days before sampled IGF-1, were associated with IGF-1 < 20 μg/L, gestational age adjusted OR 1.30 (95% CI 1.03–1.63), p = .026, and 1.57 (95% CI 1.26–1.97), p < .001 respectively. Higher levels of IGFBP-1 one day before sampled IGF-1 was also associated with IGF-1 < 20 μg/L, gestational age adjusted OR 1.74 (95% CI 1.19–2.53), p = .004.

Conclusion

In preterm infants receiving continuous infusion of rhIGF-1/rhIGFBP-3, higher levels of IL-6 and IGFBP-1 preceded lower levels of circulating IGF-1. These findings demonstrate a need to further evaluate if inflammation and/or infection suppress serum IGF-1 levels.

The trial is registered at ClinicalTrials.gov (NCT01096784).

中文翻译：

IL-6和IGFBP-1水平升高可预测在极早产儿持续输注rhIGF-1 / rhIGFBP-3期间血清IGF-1水平较低。

目的

连续静脉输注重组人胰岛素样生长因子-1 /重组人胰岛素样生长因子结合蛋白-3（rhIGF-1 / rhIGFBP- 3）极早产儿在出生的头几周内。我们评估了白介素6（IL-6）和胰岛素样生长因子结合蛋白1（IGFBP-1）水平作为低IGF-1水平的预测因子。

方法

19名极端早产儿参加了一项试验，其中9名接受了rhIGF-1 / rhIGFBP-3，而10名接受了标准的新生儿护理。在用rhIGF-1 / rhIGFBP-3干预期间，每天分析血样中的IGF-1，IL-6和IGFBP-1。

结果

积极治疗期间IGF-1值的37％小于20μg/ L。在接受治疗的婴儿中，在抽取IGF-1的前1天和2天，较高的IL-6水平与IGF-1 <20μg/ L，调整胎龄或OR 1.30（95％CI 1.03–1.63）有关，p =。 026和1.57（95％CI 1.26-1.97），p <.001。在采样IGF-1前一天，较高的IGFBP-1水平也与IGF-1 <20μg/ L，调整胎龄或OR 1.74（95％CI 1.19–2.53）相关，p = .004。