Glucose kinetics and glucoregulatory hormone levels in ventilated preterm infants on the first day of life.
Glucose production and oxidation were measured in ventilated preterm appropriate-for-gestational-age and small-for-gestational-age infants on the first day of life. Using a new technique of NaH13CO3 infusion followed by a [U-13C]glucose infusion, we measured glucose oxidation rates without measuring the CO2 production rate. Infants were studied at 18 +/- 4 h (mean +/- 1 SD) of life and received parenterally administered glucose only (4.2 +/- 0.5 mg.kg-1 x min-1). In 13 of 16 patients, the glucose production rate exceeded 1.0 mg.kg-1 x min-1. Infants born from mothers who had been receiving steroids antenatally had higher glucose production rates (2.3 +/- 1.1 mg.kg-1 x min-1) compared with infants from mothers who had not (1.1 +/- 0.8 mg.kg-1 x min-1, p = 0.036). The glucose oxidized (2.9 +/- 1.0 mg.kg-1 x min-1) was lower than the amount of glucose infused (p = 0.005) and was not different for appropriate-for-gestational-age and small-for-gestational-age infants. Plasma levels of glucose, insulin, glucagon, and total IGF-I were not correlated with glucose metabolism on the first day of life. Total IGF-II levels were negatively correlated with the rate of glucose appearance. We conclude that preterm infants on the first day of life receiving a glucose infusion of 4.2 mg.kg-1 x min-1 continue to produce glucose. The glucose oxidation rate is lower than the glucose infusion rate and the contribution of glucose oxidation to the total energy expenditure is limited.
Department of Pediatrics, Academic Hospital Rotterdam/Sophia Childrens Hospital, The Netherlands.
J B
JB
van Goudoever
E J
EJ
Sulkers
T E
TE
Chapman
V P
VP
Carnielli
T
T
Efstatopoulos
H J
HJ
Degenhart
P J
PJ
Sauer
D001786:Blood Glucose / Q000378:metabolism*; D004734:Energy Metabolism; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D005934:Glucagon / Q000097:blood; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D007236:Infant, Small for Gestational Age / Q000097:blood; D007328:Insulin / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D007335:Insulin-Like Growth Factor II / Q000378:metabolism; D007700:Kinetics; D008297:Male; D010084:Oxidation-Reduction; D012121:Respiration, Artificial
D001786:Blood Glucose; D005230:Fatty Acids, Nonesterified; D007328:Insulin; D007334:Insulin-Like Growth Factor I; D007335:Insulin-Like Growth Factor II; D005934:Glucagon