Gluconeogenesis is Not Regulated by Either Glucose or Insulin in Extremely Low Birth Weight Infants Receiving Total Parenteral Nutrition - 07/08/11
Reprint requests: Agneta Sunehag, MD, PhD, Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030.Abstract |
Objective |
To determine potential factors regulating gluconeogenesis (GNG) in extremely low birth weight infants receiving total parenteral nutrition.
Study design |
Seven infants (birth weight, 0.824 ± 0.068 kg; gestational age, 25.4 ± 0.5 weeks; postnatal age, 3.3 ± 0.2 days) were studied for 11 hours, with parenteral lipid and amino acid therapy continued at prestudy rates. Glucose was supplied at prestudy rates for the first 5 hours (period 1) and was then reduced to 6 mg/kg·min for 1 hour and further to 
3 mg/kg·min for 5 hours (period 2). A total of 2.5 mg/kg·min of the glucose was replaced by [U-13C]glucose throughout the study for measurements of glucose production and GNG. Concentrations of glucose, insulin, glucagons, and cortisol were determined.
Results |
GNG and glucose production remained unchanged (2.12 ± 0.23 vs. 1.84 ± 0.25 mg/kg·min [P = NS] and 2.44 ± 0.27 vs. 2.51 ± 0.31 mg/kg·min [P = NS], respectively), despite a 60% reduction of the glucose infusion rate and subsequent 30% (124.7 ± 10.8 to 82.6 ± 8.9 mg/dL; P = .009) and 70% (26.9 ± 4.7 to 6.6 ± 0.4 μU/mL; P = .002) decreases in glucose and insulin concentrations, respectively. Cortisol and glucagon concentrations remained unchanged.
Conclusion |
In extremely low birth weight infants receiving total parenteral nutrition, GNG is a continuous process that is not affected by infusion rates of glucose or concentrations of glucose or insulin.
Le texte complet de cet article est disponible en PDF.Mots-clés : CRP, ELBW, GNG, GPR, Ra, TPN
Plan
| Funded by the National Institutes of Health (Grant RO1 HD 37857), US Department of Agriculture (Cooperative Agreement 58-6250-6-001), and General Clinical Research Center, National Center for Research Resources (Grant NIH MO1-RR-001888). The contents of this article do not necessarily reflect the views of policies of the US Department of Agriculture, nor does any mention of trade names, commercial products, or organizations imply endorsement from the US Government. The authors declare no conflicts of interest. |
Vol 158 - N° 6
P. 891-896 - juin 2011 Retour au numéro
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