Blood-Biomarkers for Glucose Metabolism in Preterm Infants

This was an exploratory, prospective, longitudinal, cohort study that aimed to establish healthy reference levels related to growth parameters and glucose metabolites in preterm infants. This was conducted to further investigate growth and metabolic disturbances potentially related to neonatal illness. The study sample consisted of 108 preterm infants born before 32 weeks in 2018-2019 in the Capital Region of Denmark. Repetitive blood samples were acquired at the neonatal wards, while clinical data were obtained from the regional hospital medical record system. Thirty-four healthy preterm infants (31%) were identified. The ill infants were divided into four subgroups dependent on gestational age and small for gestational age. Reference levels for the growth parameters and metabolic biomarkers glucose, albumin, and adiponectin, and two glucose control indicators, glycated albumin and fructosamine, were determined for the healthy and ill subgroups. The ill extremely preterm infants had increased glucose levels (mean difference 0.71 mmol/L, 95% CI 0.23; 1.18 mmol/L) and glycated albumin (corrected; %) (mean difference 0.92 mmol/L, 95% CI 0.38 mmol/L;1.47 mmol/L) compared to the healthy infants. In ill extremely preterm infants and ill very preterm infants born small for gestational age, levels of biomarkers containing proteins were decreased. In the Ill extremely preterm infants and infants born small for gestational age, postnatal growth was continuously decreased throughout the postconceptional period. The short-term glucose-control indicator, glycated albumin (corrected; %), reflected well the high glucose levels due to its correction for the depleted plasma-protein pool.

Automated summary

This study aimed to establish healthy reference levels for growth parameters and glucose metabolites in preterm infants. The findings showed that ill preterm infants had higher glucose levels and glycated albumin values, and lower levels of biomarkers containing proteins. Additionally, postnatal growth was continuously decreased in ill infants.