Extrauterine growth and adipocytokines in appropriate-for-gestational-age preterm infants.

BACKGROUND: Extra-uterine growth retardation in preterm infants is associated with an increased risk for cardiometabolic diseases later in life. Adipocytokines are also associated with the development of cardiometabolic diseases. We examined the relationship between extra-uterine growth and serum concentrations of adipocytokines and metabolic hormones in preterm infants. METHODS: Serum concentrations of leptin, adiponectin, insulin, IL-6, TNF-α, C-peptide, GIP, GLP-1 and glucagon were measured in 38 appropriate-for-gestational-age preterm infants at birth, and at 33 and 38 weeks of postmenstrual age using a Bio-Plex 200TM suspension array system. RESULTS: Serum concentrations of leptin were not correlated with body weight at any time point. However, serum concentrations of adiponectin were correlated with body weight at all time points. Serum concentrations of IL-6 were decreased from birth to 33 and 38 weeks. Serum concentrations of TNF-α were not changed. Serum concentrations of C-peptide, GIP and glucagon increased from birth to 33 weeks, and decreased from 33 to 38 weeks. Serum concentrations of insulin and GLP-1 were not changed. CONCLUSION: Changes in serum concentrations of leptin and adiponectin showed unique profiles, thereby suggesting maldevelopment of white adipose tissue. This may affect the future development of adipose tissue and lead to increased risk for cardio-metabolic disorders. This article is protected by copyright. All rights reserved.

Micafungin versus fluconazole for prophylaxis against fungal infections in premature infants.

BACKGROUND: We conducted a comparative clinical study to evaluate the prophylactic effects of micafungin (MCFG) and fluconazole (FLCZ) on the incidence of fungal infections in extremely low-birthweight infants who were born at a gestational age of less than 26 weeks and weighed less than 1000 g. METHODS: With a combination of enteral administration of miconazole (6 mg/kg/day), FLCZ and MCFG were administered intravenously at a dose of 5 mg/kg/day and 3 mg/kg/day, respectively. The prophylaxis was classified as a failure when fungal infections were identified within the first 21 days after birth. RESULTS: The prophylaxis was successful in seven of 18 cases (39%) in the FLCZ group and 15 of 21 cases (71%) in the MCFG group, indicating that the success rate was significantly higher in the latter group. CONCLUSION: MCFG was superior to FLCZ as prophylaxis against fungal infections in extremely low-birthweight infants.

Early weight changes after birth and serum high-molecular-weight adiponectin level in preterm infants.

BACKGROUND: Extra-uterine growth retardation (EUGR) is associated with an increased risk for cardiometabolic diseases later in life. The aim of the present study was to examine the relationship between early weight change after birth in preterm infants and adiponectin (adn) multimeric complexes. METHODS: Subjects included 28 preterm infants born between weeks 24 and 33 of gestation. Serum adn multimeric complexes and the anthropometric parameters were measured in preterm infants at birth and at corrected term. RESULTS: Bodyweight (BW) decreased during the first week of life, with birthweight restored at approximately 19 days after birth. Nineteen of the subjects had EUGR at corrected term. Total (T)-adn, high-molecular-weight (H)-adn, and the ratio of H-adn to T-adn (H/T-adn) were significantly elevated at corrected term than at birth. Postmenstrual age, birthweight, birth length and lowest BW after birth were positively correlated with H-adn and H/T-adn. Weight reduction after birth was negatively correlated with H-adn. Age to restore birthweight was negatively correlated with T-adn, H-adn and H/T-adn. Stepwise multiple regression analysis indicated age to restore birthweight as the major predictor of T-adn and H-adn. DISCUSSION: Early weight changes after birth may alter serum adn level in preterm infants at corrected term. The appropriate nutritional support in the early postnatal period could reduce the prevalence of EUGR and the future risk for cardiometabolic diseases.

The ratio of high-molecular weight adiponectin and total adiponectin differs in preterm and term infants.

Adiponectin consists of three subspecies (high-, middle- and low-molecular weight adiponectin). Among these, high-molecular weight adiponectin (H-adn) is suggested to be an active form of this protein. To assess the relationship between H-adn and postnatal growth in preterm infants (PIs), serum H-adn and total adiponectin (T-adn) were measured in 46 PIs at birth and at corrected term, and 26 term infants (TI) at birth. T-adn and H-adn concentrations, and the ratio of H-adn to T-adn (H/T-adn) were significantly greater in TI and PI at corrected term than in PI at birth (p < 0.001). T-adn and H-adn concentrations in PI at corrected term were similar to those in TI, but H/T-adn in PI at corrected term was less than that in TI (p < 0.02). Stepwise multiple regression analysis revealed that the factors contributing to H/T-adn and serum concentrations of T- and H-adn in PI at corrected term were different from those in TI. These data suggest that quality of early postnatal growth in PIs is different from that in normally developed TI. Postnatal growth accompanying adipose tissue similar to TI may be important for PI to prevent future development of cardiovascular disease.

Birthweight and risk factors for cardiovascular diseases in Japanese schoolchildren.

BACKGROUND: Low birthweight (LBW) is associated with an increased risk for atherosclerotic coronary heart disease (ACHD) later in life. However, little information is currently available on the relationship between birthweight (BW) and risk factors for ACHD in children. METHODS: The relationship between BW and risk factors for ACHD was evaluated in 330 Japanese children (187 boys and 143 girls) aged between 7 and 12 years, who underwent screening for lifestyle-related diseases in Okinawa, Japan. Routine chemical methods were used to determine the serum concentrations of lipids, apolipoproteins, uric acid and glucose. Serum insulin and adiponectin were measured by sandwich enzyme-linked immunosorbent assay. RESULTS: BW was significantly correlated with serum concentrations of adiponectin (r= 0.163, P= 0.003) and uric acid (r=-0.166. P= 0.003), but not with insulin, lipids or apolipoproteins. These correlations were still significant even after adjusting for age, gender and body mass index (BMI) percentile (BW and adiponectin, r= 0.239, P= 0.000; BW and uric acid, r=-0.247, P= 0.000). In addition, BW was correlated with high-density lipoprotein-cholesterol (HDL-C) only after adjusting for age, gender and BMI percentile (r= 0.117, P= 0.034). In a stepwise multiple regression analysis, BW was a significant predictive variable for adiponectin and uric acid. However, weight velocity (weight gain/year) was a stronger predictive variable than BW for both adiponectin and uric acid. BW was not a significant predictive variable for HDL-C. Adiponectin was the strongest predictive variable for HDL-C. CONCLUSION: BW is related to serum concentrations of adiponectin and uric acid. However, weight velocity was a stronger determinant of serum adiponectin and uric acid levels than BW in Japanese schoolchildren. Thus, it may be important to control weight gain to prevent the development of ACHD in children, especially in children with LBW.