title: Biomarkers associated with bronchopulmonary dysplasia/mortality in premature infants.
abstract: Bronchopulmonary dysplasia (BPD) portends lifelong organ impairment and death. Our ability to predict BPD in first days of life is limited, but could be enhanced using novel biomarkers.
  
  
  
  Using an available clinical and urine biomarker database obtained from a prospective 113 infant cohort (birth weight ≤1,200 g and/or gestational age ≤31 wk), we evaluated the independent association of 14 urine biomarkers with BPD/mortality.
  
  
  
  Two of the 14 urine biomarkers were independently associated with BPD/mortality after controlling for gestational age (GA), small for gestational age (SGA), and intubation status. The best performing protein was clusterin, a ubiquitously expressed protein and potential sensor of oxidative stress associated with lung function in asthma patients. When modeling for BPD/mortality, the independent odds ratio for maximum adjusted urine clusterin was 9.2 (95% CI: 3.3-32.8, P < 0.0001). In this model, clinical variables (GA, intubation status, and SGA) explained 38.3% of variance; clusterin explained an additional 9.2%, while albumin explained an additional 3.4%. The area under the curve incorporating clinical factors and biomarkers was 0.941.
  
  
  
  Urine clusterin and albumin may improve our ability to predict BPD/mortality. Future studies are needed to validate these findings and determine their clinical usefulness.
authors.affiliation: Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Jessica
authors.initials: J
authors.lastname: Balena-Borneman
authors.affiliation: Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Namasivayam
authors.initials: N
authors.lastname: Ambalavanan
authors.affiliation: Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Hemant K
authors.initials: HK
authors.lastname: Tiwari
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Russell L
authors.initials: RL
authors.lastname: Griffin
authors.affiliation: Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Brian
authors.initials: B
authors.lastname: Halloran
authors.affiliation: Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: David
authors.initials: D
authors.lastname: Askenazi
mesh_terms: D000419:Albuminuria / Q000175:diagnosis* / Q000401:mortality; D015415:Biomarkers / Q000652:urine*; D001724:Birth Weight; D001997:Bronchopulmonary Dysplasia / Q000175:diagnosis / Q000401:mortality / Q000652:urine*; D051152:Clusterin / Q000652:urine; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D008297:Male; D016017:Odds Ratio; D012307:Risk Factors
chemical_list: D015415:Biomarkers; C495242:CLU protein, human; D051152:Clusterin