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 mu g/mL at 72 hours to 37.4 +/- 22.2 mu g/mL at 3 weeks; during days 3-21, it was 21.4 +/- 12 mu g/mL and correlated with GA at birth (r = 0.46, P = .001; BW: r = 0.71, P = .001; BWSDS: r = 0.42, P = .003). Furthermore, mean adiponectin during days 3-21 correlated with weight(SDS), length(SDS), and HCSDS (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.