Abstract
Aim The aim of this study is to ascertain whether the level of circulating amino acids (aa) is associated with retinopathy of prematurity (ROP). Methods This is a randomized controlled study of 55 infants born at gestational age (GA) ≤32 weeks or birth weight (BW) ≤1500 grams. Serum samples were obtained from two groups: Group A comprised of 26 preterm infants with ROP and Group B comprised of 29 preterm infants without ROP. Plasma aa levels were analyzed using liquid chromatography with tandem mass spectrometry (LC-MS/MS). Correlation test and multivariate regression analysis were used to evaluate the relationship between plasma aa levels and variables. Results The mean serum arginine and glutamine levels were significantly higher, but the mean lysine and aspartic acid levels were significantly lower in Group A, compared to Group B (p = 0.04, p = 0.002, p = 0.029, and p = 0.002, respectively). In multivariate analysis, the mean arginine and lysine levels were significantly associated with the stage of the disease (p = 0.03 and p = 0.01, respectively). No significant differences were determined between the groups in terms of alanine, asparagine, valine, leucine, phenylalanine, tyrosine, serine, proline, citrulline, cysteine, ornithine, tryptophan, methionine, threonine, taurine, and isoleucine amino acids (p > 0.05, respectively). Conclusions These results indicate a significant association between high arginine and glutamine, with low lysine and aspartic acid serum concentrations with ROP. Due to higher serum concentrations in ROP, extra arginine-glutamine supplementation in hyperoxic conditions may be unfavorable through pathways involving reactive oxygen, particularly in patients with ROP.
Highlights
Retinopathy of prematurity (ROP) is a preventable, sightthreatening condition associated with abnormal retinal vascular development that occurs only in premature infants [1]
Risk factors for the development of retinopathy of prematurity (ROP) can be summarized under two main headings as prenatal factors, such as low gestational age at birth and low birth weight, and postnatal factors such as exposure to higher oxygen levels and loss of fetomaternal interaction. ese factors lead to an increase in metabolic demands and a reduction in the production of insulin-like growth factor-I (IGF-I), which is a key factor for body growth and weight gain in postnatal period [2]
Poor general growth and low serum IGF-1 concentrations are associated with neonatal morbities such as ROP, intraventricular hemorrhage (IVH) and necrotizing enterocolitis (NEC) [3]. e synthesis of IGF-I is regulated by the availability of amino acids (AA) and depends on overall energy intake; circulating AA concentrations in preterm babies might be linked with ROP by downregulation of IGF-1 synthesis
Summary
Evaluation of Plasma Amino Acid Levels in Preterm Infants and Their Potential Correlation with Retinopathy of Prematurity. Aim. e aim of this study is to ascertain whether the level of circulating amino acids (aa) is associated with retinopathy of prematurity (ROP). E mean serum arginine and glutamine levels were significantly higher, but the mean lysine and aspartic acid levels were significantly lower in Group A, compared to Group B (p 0.04, p 0.002, p 0.029, and p 0.002, respectively). The mean arginine and lysine levels were significantly associated with the stage of the disease (p 0.03 and p 0.01, respectively). Ese results indicate a significant association between high arginine and glutamine, with low lysine and aspartic acid serum concentrations with ROP. Due to higher serum concentrations in ROP, extra arginine-glutamine supplementation in hyperoxic conditions may be unfavorable through pathways involving reactive oxygen, in patients with ROP
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