Document Detail


Cytochrome P450 (CYP2D6) genotype is associated with elevated systolic blood pressure in preterm infants after discharge from the neonatal intensive care unit.
MedLine Citation:
PMID:  21353244     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine genetic and clinical risk factors associated with elevated systolic blood pressure (ESBP) in preterm infants after discharge from the neonatal intensive care unit (NICU).
STUDY DESIGN: A convenience cohort of infants born at <32 weeks gestational age was followed after NICU discharge. We retrospectively identified a subgroup of subjects with ESBP (systolic blood pressure [SBP] >90th percentile for term infants). Genetic testing identified alleles associated with ESBP. Multivariate logistic regression analysis was performed for the outcome ESBP, with clinical characteristics and genotype as independent variables.
RESULTS: Predictors of ESBP were cytochrome P450, family 2, subfamily D, polypeptide 6 (CYP2D6) (rs28360521) CC genotype (OR, 2.92; 95% CI, 1.48-5.79), adjusted for outpatient oxygen therapy (OR, 4.53; 95% CI, 2.23-8.81) and history of urinary tract infection (OR, 4.68; 95% CI, 1.47-14.86). Maximum SBP was modeled by multivariate linear regression analysis: maximum SBP=84.8 mm Hg + 6.8 mm Hg if cytochrome P450, family 2, subfamily D, polypeptide 6 (CYP2D6) CC genotype + 6.8 mm Hg if discharged on supplemental oxygen + 4.4 mm Hg if received inpatient glucocorticoids (P=.0002).
CONCLUSIONS: ESBP is common in preterm infants with residual lung disease after discharge from the NICU. This study defines clinical factors associated with ESBP, identifies a candidate gene for further testing, and supports the recommendation to monitor blood pressure before age 3 years, as is suggested for term infants.
Authors:
John M Dagle; Tyler J Fisher; Susan E Haynes; Susan K Berends; Patrick D Brophy; Frank H Morriss; Jeffrey C Murray
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-02-24
Journal Detail:
Title:  The Journal of pediatrics     Volume:  159     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-06-14     Completed Date:  2011-08-17     Revised Date:  2014-09-17    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  104-9     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 Mosby, Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Cohort Studies
Cytochrome P-450 CYP2D6 / genetics*
Female
Gene Frequency
Genotype
Glucocorticoids / therapeutic use
Humans
Hypertension / epidemiology,  genetics*
Infant, Newborn
Infant, Premature*
Intensive Care Units, Neonatal
Male
Multivariate Analysis
Oxygen Inhalation Therapy
Patient Discharge
Polymorphism, Single Nucleotide
Retrospective Studies
Systole
Urinary Tract Infections / epidemiology
Grant Support
ID/Acronym/Agency:
K08 DK064333/DK/NIDDK NIH HHS; P30 ES05605/ES/NIEHS NIH HHS; R01 HD052953/HD/NICHD NIH HHS; R01 HD052953/HD/NICHD NIH HHS; R01 HD052953-05/HD/NICHD NIH HHS; R01 HD057192/HD/NICHD NIH HHS; R01 HD057192-03/HD/NICHD NIH HHS; R01 HD57192/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Glucocorticoids; EC 1.14.14.1/Cytochrome P-450 CYP2D6
Comments/Corrections

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