The following is the summary of “Correlation analysis of NT-proBNP (N-terminal probrain natriuretic peptide), 25-Hydroxyvitamin D, HMGB1 (High-mobility group box 1), ACTA (endogenous activin A), blood glucose level, and electrolyte level with developmental quotient scores in neonates with hypoxic-ischemic encephalopathy” published in the December 2022 issue of Pediatrics by Liu, et al.

N-terminal pro-brain natriuretic peptide (NT-proBNP), 25-hydroxyvitamin D (25-(OH) D), high-mobility group box 1 (HMGB1), endogenous activin A (ACTA), blood glucose, electrolyte, and DQ scores in hypoxic-ischemic encephalopathy (HIE). 90 infants with HIE who were admitted to their hospital between January 2018 and June 2021 were included in this retrospective analysis, and forty term infants delivered at their  hospital within the same time frame were selected at random to serve as a comparison group. Preterm infants diagnosed with HIE and term infants without HIE served as the experimental and control subjects, respectively. Mild, moderate, and severe HIE are the three categories into which neonates with HIE fall. Neonates’ brain growth was evaluated between 9 and 12 months of age using the Gesell Developmental Scale (GDS). All newborns had their NT-proBNP, (25-(OH) D), HMGB1, ACTA, electrolyte, and blood glucose levels tested and collected from their peripheral venous blood. Both groups’ general characteristics and Apgar scores were examined. Both sets of biomarkers were compared to one another, and their associations with DQ scores were investigated.

Birth weight, gestational age at birth, mode of delivery, and whether or not the mother was a first-time mother were all similar across the 2 categories (P>0.05). With a significant difference (P<0.05), the study group’s 10-minute Apgar score (5.87±0.36) was lower than that of the control group’s (9.37±0.32). The study group had higher levels of NT-proBNP, HMGB1, and ACTA than the control group (243.87±21.29 pmol/L vs. 116.98±22.19 pmol/L; 8.92±1.87 μg/L vs. 3.28±1.08 μg/L; 23.78±0.89 ng/ml vs. 2.98±0.38 ng/ml), but lower levels of 25 The severe group had significantly greater levels of NT-probNP, HMGB1, ACTA, and the occurrence of hypoglycemia compared to the moderate group and the mild group (P<0.05). In the mild group, NT-probNP, HMGB1, ACTA, and the occurrence of hypoglycemia were all lowest. The severe group had the lowest 25-(OH) D level, incidence of hyperglycemia, and electrolyte levels compared to the moderate and mild group (24.28±1.87 vs. 31.29±1.93; K+: 4.49±0.23 mmol/L vs. 4.73±0.21 mmol/L; Na+: 118.76±13.02 mmol/L vs. 134.28±12.29 mmol/L; Ca2+: 1.77±0.23 mmol/L vs. 2.35±0.26 mmol/L; Mg2+: 0.61±0.17 mmol/L vs. 0.91±0.17 mmol/L), with statistically significant differences (P<0.001). s (all P<0.05). Comparing the mild and moderate groups, the moderate group had a lower 25-(OH) D level, incidence of hyperglycemia, and electrolyte levels (all P<0.05).

The severe group (16 cases) had the lowest hyperglycemia incidence compared to the moderate group (17 cases) and the mild group (22 cases), and the differences were statistically significant (all P<0.05). Negative correlations were seen between the DQ scores of HIE neonates and NT-proBNP, HMGB1, and ACTA (r=-0.671, -0.421, and -0.518, respectively, all P<0.001). High levels of 25-(OH) D and high levels of blood glucose were strongly connected with high DQ scores (r =0.621, 0.802, both P<0.001). Potassium, sodium, calcium, and magnesium all showed positive associations with DQ scores (r=0.367, r=0.782, r=0.218, r=0.678, all P<0.001). Severity of HIE and developmental quotient scores associated with NT-proBNP, HMGB1, ACTA, 25-(OH) D, blood glucose, and electrolyte levels in infants with HIE. These biomarkers have potential for use in predicting the outcome of neonates diagnosed with HIE.