Prospective cohort analyses of data collected as part of an international randomized controlled trial. Blood samples (days 1, 3, 7, and 28), were taken for IGF-I bioassay from 283 very low birth weight infants (<1500聽g).
Early insulin treatment led to a late increase in IGF-I levels between day 7 and 28 (P聽=聽.028). In the first week of life IGF-I levels were lower in infants with early hyperglycemia; mean difference 鈭?.10聽渭g/L (95% CI 鈭?.19, 鈭?.02, P聽=聽.02). Lower levels of IGF-I at day 28 were independently associated with an increased risk of chronic lung disease, OR 3.23 (95% CI, 1.09-9.10), and greater IGF-I levels were independently associated with better weight gain, 0.10聽kg (95% CI, 0.03-0.33, P聽=聽.02).
Early intervention with insulin is related to increased IGF-I levels at 28聽days. Low IGF-I levels are associated with hyperglycemia, increased morbidity, and reduced growth. Increasing IGF-I levels may improve outcomes of very low birth weight infants.