128 Increase of IGFBP1 following Hypoxia in The Piglet

Abstract

Background:: Insulin Like Growth Factor Binding Proteins (IGFBPs) may be more directly related to ischaemic injury than factors such as pH and lactate, which relate to hypoxia and anaerobic metabolism. We sought to determine if IGFBP1 increases following a hypoxic insult in an animal model and to establish its possible role as an early predictor of outcome. Methods: 26 piglets were anaesthetised and ventilated. The oxygen intake was decreased to 3 to 7%, in order to create a hypoxic insult. Measurements of IGFBP1 were made before and in regular intervals after the insult. At 72 hours the piglets were sacrificed, the brains perfusion fixed and histologically examined. Results: There was no difference of birth weight or postnatal age of the animals between the groups. The histology score in the severe insult group was significantly higher than in the control or mild insult group (15.6 vs 0, p< 0.001). At 48 and 72 hours there was a significant difference of IGFBP1 between the groups with the short and prolonged hypoxia group having higher IGFBP1 levels (43.31 vs 77.9 μmol/L at 48 hours, 30.13 vs 79.68 μmol/L at 72 hours, p< 0.05) Conclusion: IGFBP1 is expressed after a hypoxic insult. The sustained increase may represent hepatic damage as is often seen in neonates following perinatal asphyxia. These findings need to be verified in neonates, however, timing of the insult is often not possible in babies. It may be that IGFBP1 may be used as a predictor of outcome following perinatal asphyxia in neonates.