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Association of Retinopathy of Prematurity With Low Levels of Arachidonic Acid A Secondary Analysis of a Randomized Clinical Trial

Artikel i vetenskaplig tidskrift
Författare Chatarina Löfqvist
Svetlana Najm
Gunnel Hellgren
Eva Engström
Karin Sävman
Anders K. Nilsson
Mats X. Andersson
Anna-Lena Hård
L. E. H. Smith
Ann Hellström
Publicerad i Jama Ophthalmology
Volym 136
Nummer/häfte 3
Sidor 271-277
ISSN 2168-6165
Publiceringsår 2018
Publicerad vid Institutionen för biologi och miljövetenskap
Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap
Institutionen för kliniska vetenskaper, Avdelningen för pediatrik
Sidor 271-277
Språk en
Länkar doi.org/10.1001/jamaophthalmol.2017...
Ämnesord polyunsaturated fatty-acids, preterm infants, docosahexaenoic acid, fish-oil, bronchopulmonary dysplasia, retinal angiogenesis, plasma, phospholipids, lipid emulsions, growth, neovascularization, Ophthalmology
Ämneskategorier Oftalmologi, Pediatrik

Sammanfattning

IMPORTANCE Mice with oxygen-induced retinopathy fed matched diets except for omega-3 long-chain polyunsaturated fatty acids (LC-PUFAs) vs omega-6 LC-PUFAs demonstrate relative antiangiogenic and neuroprotective associations of omega-3 LC-PUFAs. However, supplementing preterm infants with LC-PUFAs has been inconsistent in reducing major preterm morbidities. However, few studies measured serum lipid levels after supplementation. OBJECTIVE To examine the associated risk of retinopathy of prematurity (ROP) from the levels of circulating omega-3 and omega-6 LC-PUFAs. DESIGN, SETTING, AND PARTICIPANTS This longitudinal clinical study was a further analysis of serum lipid levels from a randomized controlled trial cohort of 90 infants born at gestational age (GA) less than 28 weeks. From April 4, 2013, to September 22, 2015, cord blood samples, followed by venous blood samples, were obtained at birth and at 1, 7, 14, and 28 days after birth and then at postmenstrual age (PMA) 32, 36, and 40 weeks at the neonatal intensive care unit at Sahlgrenska University Hospital in Goteborg, Sweden. MAIN OUTCOMES AND MEASURES Serum phospholipid fatty acids were transmethylated and measured by gas chromatography-mass spectrometry. Mann-Whitney test, logistic regression Spearman rank correlation, and receiver operating characteristic curve analysis were used to compare differences between infants with no ROP and infants who developed ROP. RESULTS Serum levels from 78 infants (43 male [55%]; mean [SD] GA, 25.5 [1.4] weeks) with a known ROP outcome were evaluated. Lower area under the curve (AUC) of arachidonic acid (AA) (20: 4 omega-6) was seen in infants with a later diagnosis of ROP compared with infants with no ROP in the first month of life (mean, 34.05 [95% CI, 32.10-36.00] vs 37.15 [95% CI, 34.85-39.46]; P < .05). In addition, lower levels of AA at 32 weeks' PMA were seen in infants with later severe ROP compared with in those without ROP (mean, 7.06 [95% CI, 6.60-7.52] vs 8.74 [95% CI, 7.80-9.67]; P < .001). In logistic modeling, low postnatal serum levels of AA and GA at birth identified with a sensitivity greater than 90% of infants who developed ROP. CONCLUSIONS AND RELEVANCE Low postnatal levels of the omega-6 LC-PUFAs (AA) are strongly associated with ROP development. Evaluating postnatal AA fraction after birth in addition to GA may be useful for ROP prediction.

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