Premium
Cord Blood FGF21 and Leptin as Candidate Biomarkers of Early Infant Linear Growth Velocity in a Low‐ Income Country
Author(s) -
Hack Salma,
Papp Eszter,
Shi Joy,
Dimitris Michelle,
Bandsma Robert,
Al Mahmud Abdulla,
Roth Daniel
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.890.14
Subject(s) - leptin , fgf21 , medicine , cord blood , biomarker , linear regression , infant formula , endocrinology , physiology , zoology , pediatrics , fibroblast growth factor , biology , obesity , mathematics , statistics , receptor , biochemistry
Background Early detection of infant growth faltering may enable timely clinical management and allow for the identification of modifiable biological mechanisms. Fibroblast growth factor 21 (FGF21) and leptin regulate energy metabolism, and their circulating concentrations fluctuate in response to caloric intake. FGF21 increases during times of energy deprivation and leptin increases when satiated. We aimed to preliminarily assess cord blood FGF21 and leptin as potential biomarkers of early infant linear growth. Methods In a subset of healthy term infants (n=102) from an ongoing trial of maternal vitamin D supplementation in Dhaka, Bangladesh, cord serum concentrations of FGF21 and leptin were measured using commercial ELISA kits. Infant length was measured at birth and approximately 3 months of age; length‐for‐age z‐scores (LAZ) were derived according to WHO Child Growth Standards to account for sex and actual age at measurement. Conditional velocity (cV) was the infant's change in LAZ from birth to the 3‐month visit, accounting for regression to the mean. Unadjusted associations between cV and each biomarker were explored visually and estimated using linear regression. Results Mean (SD) LAZ was −1.32 (1.08) at birth and −1.00 (0.93) at 3 months. Median FGF21 and leptin were 18.74 pg/ml (n=94) and 6.59 ng/ml (n=98), respectively. Most FGF21 values (82/94) ranged from undetectable (set to 1.55 pg/mL = 1/2 lowest standard) to 50 pg/ml, and the cV‐FGF21 association appeared linear in this range. For each 10 pg/mL increase in FGF21 (from 0 to 50 pg/mL), cV decreased by 0.12 (95%CI: 0.00, 0.24; p=0.044). When FGF21 was categorized as below limit of detection (0), detectable but below median (I), or at/above median (II) using all data (n=94), the mean difference in cV between 0 and I groups (−0.20; 95%CI: −0.56,0.16) was not significant, but the difference was larger and significant when comparing 0 and II groups (−0.41; 95%CI: −0.78, −0.04). Leptin was not significantly associated with cV (0.2 decrease in cV per 100 ng/ml increase in leptin; 95% CI: −2.1, 1.7; p=0.82). Conclusion Higher FGF21 in cord blood may signal increased risk of slower early infant linear growth in this Bangladeshi cohort. Further research is required to determine if FGF21 is a viable biomarker for early growth, or if the association with FGF21 points to a modifiable mechanism of growth faltering. Support or Funding Information The original clinical trial was funded by the Bill and Melinda Gates Foundation.