Inflammatory and growth mediators in growing preterm infants

Irfan Ahmad, Frank Zaldivar, Kensho Iwanaga, Robin Koeppel, Donna Grochow, Dan Nemet, Feizal Waffarn, Alon Eliakim, Szu Yun Leu, Dan M. Cooper

Research output: Contribution to journalArticlepeer-review


Little is understood about the optimal balance between IGF-I and antagonistic inflammatory mediators, such as IL-6, in growing preterm infants. Using a prospective cohort study, we investigated the relationship between postnatal growth of preterm infants and key growth and inflammatory mediators. We studied 51 stable, growing preterm infants (mean gestational age: 27.8 ± 0.4 weeks, mean birth weight: 1,032.8 ± 50.6 g). IL-6 and IL-1ra (reflecting stress/ inflammation) and IGF-I and GHBP (reflecting anabolic activity and GH sensitivity) were measured at enrollment and discharge using ELISA. During the observation period (mean 6.1 ± 0.34 weeks) there was a significant increase in weight (1,396 ± 81 g, p <0.0001). IGF-I increased from 46.6 ± 4.1 to 88.7 ± 5.2 ng/ml (p <0.001). In contrast, IL-6 decreased from 9.5 ± 1.0 to 2.3 ± 0.34 pg/ml (p <0.001) and IL-1ra from 6,042 ± 362 to 4,851 ± 365 ng/ml (p = 0.007). GHBP increased from 65.8 ± 6.7 to 82.5 ± 7.9 ng/ml (p = 0.003). IL-6 was inversely correlated with IGF-I (p <0.001). In addition, a multiple regression model showed IGF-I levels correlated positively and IL-6 levels inversely with various parameters of growth. Growth in preterm infants is characterized by increases in IGF-I and GHBP with simultaneous decreases in IL-6 and IL-1ra. Efforts to optimally balance inflammatory and growth mediators may benefit somatic growth in infants very early in life.

Original languageEnglish
Pages (from-to)387-396
Number of pages10
JournalJournal of Pediatric Endocrinology and Metabolism
Issue number3
StatePublished - Mar 2007
Externally publishedYes


  • IGF-I
  • IL-6
  • Preterm infant


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