Association of circulating FGF-21 levels in the first week of life and postnatal growth in hospitalized preterm infants

Kyoung Eun Joung; Dana Clausen; Aimee Herdt; Amy Presti; Ruth Snyder; Caryn Peters; Helen Christou; Christos S Mantzoros

doi:10.1016/j.metop.2020.100030

Association of circulating FGF-21 levels in the first week of life and postnatal growth in hospitalized preterm infants

Metabol Open. 2020 Mar 5:5:100030. doi: 10.1016/j.metop.2020.100030. eCollection 2020 Mar.

Authors

Kyoung Eun Joung^{1

2}, Dana Clausen³, Aimee Herdt^{3

4}, Amy Presti^{3

4}, Ruth Snyder⁴, Caryn Peters^{3

4}, Helen Christou^{5

2}, Christos S Mantzoros^{6

7

2}

Affiliations

¹ Division of Neonatology and Newborn Medicine, Department of Pediatrics, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA.
² Harvard Medical School, 75 Shattuck St., Boston, MA, 02115, USA.
³ Biomedical Research Institute of New Jersey, 140 E Hanover Ave, Cedar Knolls, NJ, 07927, USA.
⁴ Department of Pediatrics, Goryeb Children's Hospital and Morristown Medical Center/Atlantic Health System, 100 Madison Ave, Morristown, NJ, 07960, USA.
⁵ Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA.
⁶ Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA, 02215, USA.
⁷ Section of Endocrinology, Boston VA Healthcare System, Jamaica Plain, MA, 02130, USA.

Abstract

Background: The role of fetal and neonatal growth in the development of adult-onset diseases such as obesity and metabolic syndrome has become increasingly appreciated. Fibroblast growth factor-21 (FGF-21) is known as a regulator of glucose and lipid metabolism. FGF-21 levels are elevated in obese adults and children. The role of FGF-21 in neonatal growth in preterm infants is not known.

Objectives: We aimed to evaluate the association of circulating FGF-21 levels in the first week of life and neonatal growth parameters at the time of discharge from NICU.

Methods: We performed a longitudinal study of 25 preterm neonates admitted to NICU. Blood samples were collected at two time points: within 24 h of life (T1), and 24-96 h after the first blood draw (T2). FGF-21 levels were measured in plasma by ELISA. Weight, length, BMI and their Z-scores were measured at the time of birth and discharge.

Results: The FGF-21 levels were significantly higher at T2 than at T1 (p < 0.001). FGF-21 levels at both time points were positively correlated with gestational age (r = 0.43, p = 0.03). FGF-21 at T1 was positively associated with weight Z-score (β = 0.19, p = 0.001) and length Z-score at discharge (β = 0.21, p = 0.03).

Conclusions: Circulating FGF-21 levels increase significantly in the first week, and the FGF-21 levels within the first 24 h are positively associated with weight and length Z-scores at discharge in preterm infants. These results suggest that FGF-21 may be involved in growth and developmental maturation.

Keywords: BMI, body mass index; CI, confidence interval; FGF-21; FGF-21, fibroblast growth factor-21; Gestational age; Growth; PMA, postmenstrual age; Preterm neonate; Weight gain.