Growth factors of premature infants in relation to parenteral nutrition during the first month of life
2001
Challa, A. | Vantziou, S. | Cholevas, V. | Giapros, V. | Andronikou, S.
The changes in the circulating levels of growth factors were followed during the first month of life in order to determine any effects of parenteral nutrition on insulin-like growth factors in preterm infants. Thirty-five preterm infants were assigned into two groups. Group one (n = 21, gestational age (GA) 32.1 +/- 1.8 wks, birth weight (BW) 1676 +/- 112 g) was receiving total parenteral nutrition (TPN) for the first 2-11 days and the other group (n = 14, GA 31.7 +/- 1.9 wks, BW 1700 +/- 96 g) was milk fed from the 2nd day of life. Serum total and free IGF-I and IGFBP-3 concentrations were determined and auxologic measurements were carried out. One month after birth total and free IGF-I and IGFBP-3 circulating levels had increased similarly in both study groups. However on day 15 the TPN group neonates while they were on lower calorie and protein intakes demonstrated smaller changes in the total IGF-I and IGFBP-3 peptides (IGF-I: 36.3 +/- 3.9 vs 58.6 +/- 10.6 ng/mL in the milk fed group, P < 0.05; IGFBP-3: 0.50 +/- 0.04 vs 0.60 +/- 0.07 microgram/mL, P < 0.05). Their body weight gain was also lower for the same period (1681 +/- 112 vs 1805 +/- 92 g in the milk fed group). No significant differences could be seen in the free IGF-I levels and the free to total IGF-I ratio. However the weight gain was better correlated with free IGF-I and the intake of calories and protein in the TPN group (r = 0.7, P < 0.001, r = 0.5, P < 0.01 and r = 0.5, P < 0.001 respectively) than in the milk fed group (r = 0.6, P < 0.05, r = 0.2 and r = 0.1, NS). Whether increasing the energy intake with TPN will enhance the growth peptides and weight gain which would be of great clinical importance, needs to be verified.
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