Changes in serum adiponectin levels from birth to term-equivalent age are associated with postnatal weight gain in preterm infants

FGF21 via mitochondrial lipid oxidation promotes physiological vascularization in a mouse model of Phase I ROP

Hyperglycemia in early postnatal life of preterm infants with incompletely vascularized retinas is associated with increased risk of potentially blinding neovascular retinopathy of prematurity (ROP). Neovascular ROP (Phase II ROP) is a compensatory but ultimately pathological response to the suppression of physiological postnatal retinal vascular development (Phase I ROP). Hyperglycemia in neonatal mice which suppresses physiological retinal vascular growth is associated with decreased expression of systemic and retinal fibroblast growth factor 21 (FGF21). FGF21 administration promoted and FGF21 deficiency suppressed the physiological retinal vessel growth. FGF21 increased serum adiponectin (APN) levels and loss of APN abolished FGF21 promotion of physiological retinal vascular development. Blocking mitochondrial fatty acid oxidation also abolished FGF21 protection against delayed physiological retinal vessel growth. Clinically, preterm infants developing severe neovascular ROP (versus non-severe ROP) had a lower total lipid intake with more parenteral and less enteral during the first 4 weeks of life. Our data suggest that increasing FGF21 levels in the presence of adequate enteral lipids may help prevent Phase I retinopathy (and therefore prevent neovascular disease).

The effect of M technique massage on behavioral state and weight gain in preterm neonates: A randomized controlled trial

This study aimed to investigate the effect of M technique massage on behavioral state and weight gain in preterm neonates admitted to neonatal intensive care unit (NICU). This was a randomized controlled trial study in which a total of 64 preterm neonates were randomly allocated to intervention and control group. Intervention group received M technique massage and control group received routine care. Neonatal weight and behavioral state were measured for two weeks. After intervention, no statistically significant difference was found between groups in terms of neonatal weight (mean difference: 44.03, 95% CI [-180.66, 268.74]). At baseline, the mean score for behavioral state response was 5.84 ± 2.20 (mean ± SD) in control group and 5.68 ± 2.15 (mean ± SD) in intervention group and the difference was not significant (mean difference: 0.16, 95% CI [-1.21, 1.52]), but 2 weeks later, and also, after intervention, a statistically significant difference was found between groups (mean difference: 2.16, 95% CI [1.19, 3.17]) and (mean difference: 3.03, 95% CI [2.15, 3.91]), respectively, meaning that it was significantly lower in intervention group compared with control group. According to the findings, massage with M technique in premature neonates can have a positive effect on behavioral state, but no effect on their weight gain.

PGC-1α activity and mitochondrial dysfunction in preterm infants

Extremely low gestational age neonates (ELGANs) are born in a relatively hyperoxic environment with weak antioxidant defenses, placing them at high risk for mitochondrial dysfunction affecting multiple organ systems including the nervous, respiratory, ocular, and gastrointestinal systems. The brain and lungs are highly affected by mitochondrial dysfunction and dysregulation in the neonate, causing white matter injury (WMI) and bronchopulmonary dysplasia (BPD), respectively. Adequate mitochondrial function is important in providing sufficient energy for organ development as it relates to alveolarization and axonal myelination and decreasing oxidative stress via reactive oxygen species (ROS) and reactive nitrogen species (RNS) detoxification. Peroxisome proliferator-activated receptor gamma coactivator-1 alpha (PGC-1α) is a master regulator of mitochondrial biogenesis and function. Since mitochondrial dysfunction is at the root of WMI and BPD pathobiology, exploring therapies that can regulate PGC-1α activity may be beneficial. This review article describes several promising therapeutic agents that can mitigate mitochondrial dysfunction through direct and indirect activation and upregulation of the PGC-1α pathway. Metformin, resveratrol, omega 3 fatty acids, montelukast, L-citrulline, and adiponectin are promising candidates that require further pre-clinical and clinical studies to understand their efficacy in decreasing the burden of disease from WMI and BPD in preterm infants.

Cord and Early Childhood Plasma Adiponectin Levels and Autism Risk: A Prospective Birth Cohort Study

Emerging research suggests that adiponectin, a cytokine produced by adipose tissue, may be implicated in ASD. In this prospective birth cohort study (n = 847), we assessed the association between cord, early childhood plasma adiponectin and the risk of developing ASD. ASD was defined based on ICD codes of physician diagnosis. Cord adiponectin levels were inversely associated with ASD risk (aOR 0.50; 95% CI 0.33, 0.77), independent of preterm birth, early childhood adiponectin and other known ASD risk factors. Early childhood adiponectin, assessed prior to ASD diagnosis, was associated with lower risk of ASD, which attenuated after adjusting for cord adiponectin, indicating the relative importance of cord adiponectin in ASD risk. Further research is warranted to confirm our findings and elucidate biological mechanisms.

Blood adiponectin concentration at birth in small for gestational age neonates: A meta-analysis

AIMS

Small for gestational age (SGA) is associated with increased rates of neonatal mortality and morbidity. Adiponectin secreted from adipose tissue is implicated in the etiology of death and illness during infancy. SGA is also a likely risk factor for the development of metabolic and clinical complications in adulthood. The present study was performed to determine whether SGA neonates and healthy controls show differences in blood adiponectin concentration at birth.

METHODS

Databases were searched to identify English-language studies providing the numbers of SGA neonates, the numbers of healthy controls, and the means and standard deviations (SDs) of blood adiponectin concentrations at birth in both groups. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). A meta-analysis was performed to summarize the standardized mean differences (SMDs) in blood adiponectin concentration between SGA neonates and healthy controls.

RESULTS

The results summarized from five good quality (i.e., NOS score ≥ 5) studies involving 253 neonates showed that blood adiponectin concentration was significantly lower in SGA neonates than in healthy controls (P = 0.016), and the effect was moderate (i.e., SMD = 0.4-0.7).

CONCLUSIONS

Synthetic evidence indicated that blood adiponectin concentration at birth is lower in SGA neonates than in healthy controls.

Maternal and Cord Blood Adiponectin Concentrations in Small for Gestational Age: A Meta-Analysis

Background: Adiponectin, which may have a growth-promoting effect through its insulin-sensitizing action, is thought to play a key role in fetal growth. This study was performed to determine whether maternal and/or cord blood adiponectin concentrations differ between small for gestational age (SGA) and healthy controls. Methods: Databases were searched to identify good quality English language studies providing the number of SGA and healthy controls, and the means and standard deviations of maternal or cord blood adiponectin concentration in both groups. A meta-analysis was performed to summarize the standardized mean differences (SMDs) in maternal and cord blood adiponectin concentrations between SGA and healthy controls. Results: There was no statistically significant difference in maternal blood adiponectin concentration between SGA and healthy controls (n = 8, p = 0.951). However, cord blood adiponectin concentration was significantly lower in SGA than in healthy controls (n = 6, p = 0.028), and the effect was large (i.e., SMD >0.7). Conclusions: Maternal blood adiponectin concentration is not low in SGA compared with healthy controls. However, SGA shows lower cord blood adiponectin concentration than healthy controls.

Contribution of relative leptin and adiponectin deficiencies in premature infants to chronic intermittent hypoxia: Exploring a new hypothesis

Chronic intermittent hypoxia (CIH) occurs frequently in premature infants who have apnea of prematurity. Immaturity of the respiratory network from low central respiratory drive and the greater contribution of the carotid body on baseline breathing leads to respiratory instability in premature infants presenting as apnea and periodic breathing. During the 2nd week after birth, the smallest and the youngest premature infants have increased frequency of apnea and periodic breathing and associated oxygen desaturations that can persist for weeks after birth. CIH increases the production of reactive oxygen species that causes tissue damage. Premature infants have decreased capacity to scavenge reactive oxygen species. Oxidative injury is the cause of many of the co-morbidities that are seen in premature infants. In this review we discuss who low fat mass and the resulting relative deficiencies in leptin and adiponectin could contribute to the increase frequency of oxygen desaturations that occurs days after birth in the smallest and youngest premature infants. Leptin is a central respiratory stimulant and adiponectin protects the lung from vascular leak, oxidative injury and vascular remodeling.

Enhanced nutrition improves growth and increases blood adiponectin concentrations in very low birth weight infants

Background

Adequate nutrient supply is essential for optimal postnatal growth in very low birth weight (VLBW, birth weight<1,500 g) infants. Early growth may influence the risk of metabolic syndrome later in life.

Objective

To evaluate growth and blood metabolic markers (adiponectin, leptin, and insulin-like growth factor-1 (IGF-1)) in VLBW infants participating in a randomized nutritional intervention study.

Design

Fifty VLBW infants were randomized to an enhanced nutrient supply or a standard nutrient supply. Thirty-seven infants were evaluated with growth measurements until 2 years corrected age (CA). Metabolic markers were measured at birth and 5 months CA.

Results

Weight gain and head growth were different in the two groups from birth to 2 years CA (weight gain: p_interaction=0.006; head growth: p_interaction=0.002). The intervention group improved their growth z-scores after birth, whereas the control group had a pronounced decline, followed by an increase and caught up with the intervention group after discharge. At 5 months CA, adiponectin concentrations were higher in the intervention group and correlated with weight gain before term (r=0.35) and nutrient supply (0.35≤r≤0.45). Leptin concentrations correlated with weight gain after term and IGF-1 concentrations with length growth before and after term and head growth after term (0.36≤r≤0.53).

Conclusion

Enhanced nutrient supply improved early postnatal growth and may have prevented rapid catch-up growth later in infancy. Adiponectin concentration at 5 months CA was higher in the intervention group and correlated positively with early weight gain and nutrient supply. Early nutrition and growth may affect metabolic markers in infancy.

Clinical Trial Registration (ClinicalTrials.gov) no.: NCT01103219

Review: adiponectin in retinopathy

Neovascular eye diseases are a major cause of blindness including retinopathy of prematurity, diabetic retinopathy and age-related macular degeneration in which new vessel formation is driven by hypoxia or metabolic abnormalities affecting the fuel supply. White-adipose-tissue derived adipokines such as adiponectin modulate metabolic responses. Increasing evidence shows that lack of adiponectin may result in retinal neovascularization. Activation of the adiponectin pathway may in turn restore energy metabolism, to suppress the drive for compensatory but ultimately pathological neovessels of retinopathy. In this review, we will summarize our current knowledge of the role of adiponectin in eye diseases of premature infants, diabetic patients as well as the elderly. Further investigations in this field are likely to lead to new preventative approaches for these diseases.

Early Surge in Circulatory Adiponectin Is Associated With Improved Growth at Near Term in Very Preterm Infants

CONTEXT

Adiponectin enhances insulin sensitivity and may play a role in fetal and postnatal growth.

OBJECTIVE

This study aimed to determine whether early postnatal adiponectin concentration change is related to postnatal growth in very preterm infants.

SETTING, DESIGN, AND PATIENTS

This was an in-hospital, prospective, longitudinal cohort study of 52 preterm infants with a gestational age (GA) of 26.0 ± 1.9 (SD) weeks and birth weight (BW) of 889 ± 284 g.

INTERVENTIONS

An analysis of adiponectin was performed on cord blood at birth and peripheral blood at 72 hours, day 7, and then weekly until postmenstrual age (PMA) 40 weeks. Weight, length, and head circumference (HC) measurement was performed weekly and SD scores (SDS) calculated. Energy and protein intake was calculated daily from birth until PMA 35 weeks.

RESULTS

Mean adiponectin concentration increased from 6.8 ± 4.4 μg/mL at 72 hours to 37.4 ± 22.2 μg/mL at 3 weeks; during days 3-21, it was 21.4 ± 12 μg/mL and correlated with GA at birth (r = 0.46, P = .001; BW: r = 0.71, P < .001; BW(SDS): r = 0.42, P = .003). Furthermore, mean adiponectin during days 3-21 correlated with weight(SDS), length(SDS), and HC(SDS) (r = 0.62, 0.65, and 0.62, respectively; all P < .001) at PMA 35 wk). Energy intake (kcal/kg/d) correlated with mean adiponectin during days 3-21 (r = 0.35, P < .013).

CONCLUSIONS

In very preterm infants, adiponectin concentrations increased markedly in the first 3 weeks, and a greater increase was associated with improved postnatal growth.

Dietary ω-3 polyunsaturated fatty acids decrease retinal neovascularization by adipose-endoplasmic reticulum stress reduction to increase adiponectin

BACKGROUND

Retinopathy of prematurity (ROP) is a vision-threatening disease in premature infants. Serum adiponectin (APN) concentrations positively correlate with postnatal growth and gestational age, important risk factors for ROP development. Dietary ω-3 (n-3) long-chain polyunsaturated fatty acids (ω-3 LCPUFAs) suppress ROP and oxygen-induced retinopathy (OIR) in a mouse model of human ROP, but the mechanism is not fully understood.

OBJECTIVE

We examined the role of APN in ROP development and whether circulating APN concentrations are increased by dietary ω-3 LCPUFAs to mediate the protective effect in ROP.

DESIGN

Serum APN concentrations were correlated with ROP development and serum ω-3 LCPUFA concentrations in preterm infants. Mouse OIR was then used to determine whether ω-3 LCPUFA supplementation increases serum APN concentrations, which then suppress retinopathy.

RESULTS

We found that in preterm infants, low serum APN concentrations positively correlate with ROP, and serum APN concentrations positively correlate with serum ω-3 LCPUFA concentrations. In mouse OIR, serum total APN and bioactive high-molecular-weight APN concentrations are increased by ω-3 LCPUFA feed. White adipose tissue, where APN is produced and assembled in the endoplasmic reticulum, is the major source of serum APN. In mouse OIR, adipose endoplasmic reticulum stress is increased, and APN production is suppressed. ω-3 LCPUFA feed in mice increases APN production by reducing adipose endoplasmic reticulum stress markers. Dietary ω-3 LCPUFA suppression of neovascularization is reduced from 70% to 10% with APN deficiency. APN receptors localize in the retina, particularly to pathologic neovessels.

CONCLUSION

Our findings suggest that increasing APN by ω-3 LCPUFA supplementation in total parental nutrition for preterm infants may suppress ROP.

Preterm infants have altered adiponectin levels at term-equivalent age even if they do not present with extrauterine growth restriction

BACKGROUND/AIMS

This study aimed to investigate total adiponectin (T-Ad) and high-molecular-weight adiponectin (HMW-Ad) levels in preterm infants at term-equivalent age and to assess the relationship between adiponectin levels and early postnatal growth.

METHODS

The study included 43 term infants and 58 preterm infants born at 34 weeks' gestation or less. T-Ad and HMW-Ad levels were measured in the preterm infants at birth and at term-equivalent age, and in the term infants at birth. Adiponectin levels were statistically compared between preterm and term infants to evaluate the association between postnatal growth and changes in the adiponectin levels in preterm infants.

RESULTS

The T-Ad levels were higher and the ratio of HMW-Ad to T-Ad (HMW%) was lower in preterm infants at term-equivalent age than in term infants. Further, body weight SD score changes were positively associated with T-Ad and HMW-Ad increases in preterm infants from birth to term-equivalent age. The HMW% changes had a negative association only with HMW% in cord blood.

CONCLUSION

Preterm infants have altered adiponectin levels at term-equivalent age. Further, postnatal growth may contribute to adiponectin increases from birth to term-equivalent age, although HMW% changes might be regulated before birth at least up to term-equivalent age in preterm infants.

Accumulation of subcutaneous fat, but not visceral fat, is a predictor of adiponectin levels in preterm infants at term-equivalent age

BACKGROUND

Preterm infants have altered fat tissue development, including a higher percentage of fat mass and increased volume of visceral fat. They also have altered adiponectin levels, including a lower ratio of high-molecular-weight adiponectin (HMW-Ad) to total adiponectin (T-Ad) at term-equivalent age, compared with term infants.

AIMS

The objective of this study was to investigate the association between adiponectin levels and fat tissue accumulation or distribution in preterm infants at term-equivalent age.

STUDY DESIGN

Cross-sectional clinical study.

SUBJECTS

Study subjects were 53 preterm infants born at ≤34weeks gestation with a mean birth weight of 1592g.

OUTCOME MEASURES

Serum levels of T-Ad and HMW-Ad were measured and a computed tomography (CT) scan was performed at the level of the umbilicus at term-equivalent age to analyze how fat tissue accumulation or distribution was correlated with adiponectin levels.

RESULTS

T-Ad (r=0.315, p=0.022) and HMW-Ad levels (r=0.338, p=0.013) were positively associated with subcutaneous fat area evaluated by performing CT scan at term-equivalent age, but were not associated with visceral fat area in simple regression analyses. In addition, T-Ad (β=0.487, p=0.003) and HMW-Ad levels (β=0.602, p<0.001) were positively associated with subcutaneous fat tissue area, but they were not associated with visceral fat area also in multiple regression analyses.

CONCLUSION

Subcutaneous fat accumulation contributes to increased levels of T-Ad and HMW-Ad, while visceral fat accumulation does not influence adiponectin levels in preterm infants at term-equivalent age.

Maternal, umbilical arterial and umbilical venous 25-hydroxyvitamin D and adipocytokine concentrations in pregnancies with and without gestational diabetes

OBJECTIVE

Gestational diabetes mellitus (GDM) has been associated with inflammation as well as Vitamin D insufficiency. While Vitamin D has anti-inflammatory properties, relationships between Vitamin D and inflammatory markers remain unexplored in GDM. Therefore, this case--control study investigated adipocytokine and Vitamin D [25(OH)D] concentrations and correlations in GDM and control women, as well as their neonates.

DESIGN/PARTICIPANTS/MEASUREMENTS

seventy-three women participated: 36 GDM and 37 controls. Maternal samples were drawn at 31 weeks. Umbilical arterial and venous samples were collected at birth. 25(OH)D and adipocytokine concentrations were compared for GDM vs control maternal, umbilical arterial and venous samples. Correlations were explored between biochemical results, maternal and neonatal demographics.

RESULTS

Compared with age- and weight-matched control participants, GDM women had significantly lower concentrations of 25(OH)D (77·3 ± 24·3 vs 93·2 ± 19·2 nm/l; P = 0·009); adiponectin (17·5 ± 11·8 vs 34·1 ± 20·3 μg/ml, P < 0·001); resistin (25·4 ± 9·1 vs 31·9 ± 12·1 ng/ml, P = 0·045); and plasminogen activator inhibitor-1 (PAI-1) 13·9 ± 10·0 vs 21·0 ± 12·6 ng/ml, P = 0·038), while delivering 1 week earlier (38·2 ± 1·2 vs 39·5 ± 0·9 weeks, P < 0·001). GDM maternal 25(OH)D concentrations positively correlated with PAI-1, IL-8 and TNF-α concentrations. Umbilical 25(OH)D concentrations were not significantly different in GDM vs control offspring, whereas adiponectin, resistin and PAI-1 concentrations were significantly lower in GDM offspring.

CONCLUSIONS

GDM women had lower 25(OH)D concentrations than controls, while neonatal umbilical concentrations of 25(OH)D did not differ. GDM maternal and GDM offspring had lower adiponectin, resistin and PAI-1 concentrations compared with controls. Results suggest that both GDM women and their offspring demonstrate abnormal adipocytokine patterns.

Changes in plasma adipokines in prepubertal children with a history of extrauterine growth restriction

OBJECTIVE

Because nutritional support in perinatal life has been associated with metabolic programming, children with a history of extrauterine growth restriction (EUGR) might display alterations in the adipocyte and in the secretion of adipokines. The aim of this study was to assess adiponectin, resistin, and leptin concentrations in prepubertal children with a history of EUGR, and to determine the potential correlation between these adipokines and metabolic parameters.

METHODS

This case-control study sample included 38 prepubertal children with a history of EUGR and a control group of 123 healthy children of similar age and sex. Anthropometric measures and blood pressure were assessed. Biochemical markers and blood adipokine concentrations (adiponectin, resistin, and leptin) were evaluated.

RESULTS

Adiponectin concentration was significantly lower in the EUGR group compared with controls (EUGR: 11.49 ± 6.07 versus control: 25.72 ± 10.13 μg/mL), and resistin concentration was higher (EUGR: 20332.95 ± 6401.25 versus control: 8056.31 ± 3823.63 pg/mL), even after adjustment for gestational age, weight, and size at birth. Systolic blood pressure was associated with adipokines concentrations in the EUGR group (P < 0.001). In EUGR children adiponectin was associated with high-density lipoprotein cholesterol (P = 0.042), whereas resistin was associated with carbohydrate metabolism parameters (P < 0.001).

CONCLUSIONS

Early postnatal malnutrition in EUGR children could program adipose tissue. Plasma adipokines can be measured in childhood to identify precocious changes that may be associated with a higher risk for metabolic syndrome or cardiovascular disease later in life.

Neonatal cord blood adiponectin and insulin levels in very low birth weight preterm and healthy full-term infants

BACKGROUND

There are few studies concerning adiponectin and insulin concentration in cord blood of very low birth weight (VLBW) preterm and full-term newborns, small and appropriate for gestational age (GA).

AIM

To compare adiponectin and insulin concentrations between preterm and full-term infants, and to determine their relation with birth weight (BW) and size for GA.

METHODS

A cross-sectional study of VLBW preterm newborns with GA < 32 weeks and BW < 1500 g, and full-term newborns with GA > 37 weeks born at our hospital between January 2010 and May 2011, was conducted.

EXCLUSION CRITERIA

major congenital malformation, inborn errors of metabolism, chromosomal anomalies. Adiponectin was determined by enzimoimunoassay with ELISA kits (R&D Systems, Minneapolis, MN) and insulin was assayed by chemiluminescence method.

RESULTS

A total of 127 newborns were studied, 55 VLBW preterm (28 SGA), and 72 full-term (7 SGA). Insulin cord blood concentrations in preterm and full-term newborns were similar. Adiponectin concentrations were significantly lower in preterm than in full-term infants: 1.57 ± 0.74 pg/ml versus 2.4 ± 0.22 pg/ml (p < 0.001), respectively. Regression analyses showed that, after controlling for several neonatal and maternal factors, preterm birth was the only significant predictor of adiponectin concentrations.

CONCLUSION

Being born prematurely is the main determinant factor for lower adiponectin concentration in umbilical cord blood of newborns.

Massage improves growth quality by decreasing body fat deposition in male preterm infants

OBJECTIVES

To assess the effect of massage on weight gain and body fat deposition in preterm infants.

STUDY DESIGN

Preterm infants (29-32 weeks) were randomized to the massage group (n = 22, 12 girls, 10 boys) or the control group (n = 22, 12 girls, 10 boys). Treatment was masked with massage or control care administered twice-daily by licensed massage therapists (6 d/wk for 4 weeks). Body weight, length, Ponderal Index (PI), body circumferences, and skinfold thickness (triceps, mid-thigh, and subscapular [SSF]) were measured. Circulating insulin-like growth factor I, leptin, and adiponectin levels were determined by enzyme-linked immunosorbent assay. Daily dietary intake was collected.

RESULTS

Energy and protein intake as well as increase in weight, length, and body circumferences were similar. Male infants in the massage group had smaller PI, triceps skinfold thickness, mid-thigh skinfold thickness, and SSF and increases over time compared with control male infants (P < .05). Female infants in the massage group had larger SSF increases than control female infants (P < .05). Circulating adiponectin increased over time in control group male infants (group × time × sex interaction, P < .01) and was correlated to PI (r = 0.39, P < .01).

CONCLUSIONS

Twice-daily massage did not promote greater weight gain in preterm infants. Massage did, however, limit body fat deposition in male preterm infants. Massage decreased circulating adiponectin over time in male infants with higher adiponectin concentrations associated with increased body fat. These findings suggest that massage may improve body fat deposition and, in turn, growth quality of preterm infants in a sex-specific manner.

Insulin resistance and adiponectin levels are associated with height catch-up growth in pre-pubertal Chinese individuals born small for gestational age

Abstracts

Adiponectin in breast milk: relation to serum adiponectin concentration in lactating mothers and their infants

AIMS

  The aims of the study were to determine human breast milk adiponectin concentration and to investigate its relationship with serum adiponectin concentration in lactating mothers and their infants and also to evaluate the relationship between serum adiponectin concentration and anthropometric parameters in nurses and infants.

METHODS

  We enrolled 60 healthy term breastfed (BF) infants and their lactating mothers. Adiponectin was determined by radioimmunoassay test in serum and by enzyme-linked immunosorbent assay test in human milk (HM). Infants' and mothers' anthropometric parameters were measured.

RESULTS

  Median (25‰, 75‰) adiponectin concentration in HM was 9.99 (3.59, 20.52) ng/mL. Serum adiponectin concentration in infants was 60.49 (45.76, 74.24) μg/mL and in lactating mothers 21.14 (12.61, 29.66) μg/mL. Adiponectin concentration in HM correlated positively with adiponectin in mothers' serum; r = 0.60 (p < 0.001) and in infants' serum r = 0.37 (p = 0.015). Adiponectin in HM correlated negatively with infants' age r = -0.3 (p = 0.04). Infants' serum adiponectin correlated negatively with their weight r = -0.35 (p = 0.005), length r = -0.35 (p = 0.006) and age r = -0.46 (p < 0.001) and mothers' serum adiponectin with their weight r = -0.37 (p = 0.02) and body mass index r = -0.45 (p = 0.004).

CONCLUSIONS

  The observed correlations between adiponectin in mothers, HM and BF infants may be suggestive for a metabolic link between nurses and infants through milk.

Hypoadiponectinemia in extremely low gestational age newborns with severe hyperglycemia--a matched-paired analysis

Background

Hyperglycemia is commonly observed in extremely low gestational age newborns (ELGANs) and is associated with both increased morbidity and mortality. The objective of this study was to examine the relationship between neonatal hyperglycemia and adiponectin levels in ELGANs.

Methodology/Principal Findings

Ten preterm infants between 22+6/7 and 27+3/7 weeks’ gestation with neonatal hyperglycemia (defined as pre-feeding blood glucose levels above 200mg/dl on two consecutive measurements with a maximum parenteral glucose infusion of 4mg/kg*min⁻¹) formed the case cohort of this study. To every single patient of this case cohort a patient with normal fasting ( = pre-feeding) blood glucose levels was matched in terms of gestational age and gender. Adiponectin ELISAs were performed both at onset of hyperglycemia and at term-equivalent age.

In the case cohort 9/10 patients had to be treated with insulin for 1–26 days (range 0.01–0.4 IU/kg*h⁻¹). Compared to matched-paired controls, significant hypoadiponectinemia was observed at onset of hyperglycemia in these affected patients (6.9µg/ml versus 15.1µg/ml, p = 0.009). At term equivalent age, normoglycemia without any insulin treatment was found in both groups. Moreover, adiponectin levels at that time were no longer significantly different (12.3µg/ml versus 20.0µg/ml; p = 0.051) possibly indicating a mechanistic relevance of this adipokine in regulating insulin sensitivity in ELGANs.

Conclusions/Significance

Decreased circulating adiponectin levels are correlated with hyperglycemia in ELGANs and may contribute to the pathogenesis of impaired glucose homeostasis in these infants. These findings suggest that adiponectin might be a potential future drug target for the potentially save treatment of hyperglycemia in pre-term infants.