Reduced serum Dickkopf-1 levels as a potential supportive biomarker for the development and severity of retinopathy of prematurity: a prospective observational clinical study.

Authors

Nuriye Emiroğlu, Hasan Çetin, Hüseyin Altunhan, Günhal Şatırtav, Saime Uygun

Published in

Frontiers in pediatrics. Volume 14. Pages 1917348. Epub Sep 28, 2026.

Abstract

Retinopathy of prematurity (ROP) involves impaired retinal vascular development, in which the Wnt/β-catenin signaling pathway plays a pivotal role in retinal vasculogenesis and angiogenesis. Dickkopf-1 (DKK-1) is a key endogenous inhibitor of this pathway. This study aimed to evaluate serum DKK-1 levels in preterm infants and explore its potential as a supportive biomarker associated with ROP development and severity.
In this prospective observational clinical study, preterm infants with a gestational age ≤32 weeks or birth weight ≤1500 g were enrolled. Serum DKK-1 levels were measured via ELISA. ROP was classified according to the International Classification of Retinopathy of Prematurity (ICROP). Clinical characteristics and DKK-1 levels were compared between infants with ROP and a control group. Diagnostic performance was evaluated using Receiver Operating Characteristic (ROC) analysis, and independent risk factors were identified via multivariable logistic regression.
A total of 60 preterm infants were included, of whom 39 had ROP and 21 served as controls. Serum DKK-1 levels were significantly lower in infants with ROP compared to the control group (median 456.1pg/mL vs. 537.2pg/mL; p = 0.033). A stepwise decline in DKK-1 levels was observed as disease severity increased, with the lowest levels found in the treatment-requiring (TR) ROP subgroup. Although the overall comparison among the three groups did not reach statistical significance (Kruskal-Wallis, p = 0.066), a progressive decline in DKK-1 levels with increasing disease severity was observed. ROC analysis for TR-ROP vs. controls showed an area under the curve (AUC) of 0.679 (p = 0.041), with 76.2% sensitivity and 75.0% specificity at a cut-off of 480.41pg/mL. Multivariable logistic regression revealed that gestational age was the only independent predictor for ROP (p = 0.002), while DKK-1 levels showed a biological but not independent association in the model (p = 0.199).
Reduced serum DKK-1 levels were associated with the presence and increasing severity of ROP. Although DKK-1 was not an independent predictor in multivariable analysis, these findings suggest that it may serve as a potential supportive biomarker for identifying infants at increased risk of severe ROP. Further large-scale, multicenter studies are needed to validate its clinical utility and to clarify its role in the Wnt/β-catenin signaling pathway.

PMID:
42865563
Bibliographic data and abstract were imported from PubMed on 13 Oct 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.