ArticleFrontiers in pediatrics2026
Reduced serum Dickkopf-1 levels as a potential supportive biomarker for the development and severity of retinopathy of prematurity: a prospective observational clinical study.
Article in Frontiers in pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: 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. Methods: 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. Results: 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; Conclusion: 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.
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