Splanchnic bed metabolism of glucose in preterm neonates.
BACKGROUND
Glucose is a major oxidative substrate for intestinal energy generation in neonatal animals; however, few data in preterm infants are available. Early administration of enteral nutrition, including glucose, may be an effective strategy to support intestinal adaptation to extrauterine life in preterm neonates.


OBJECTIVE
The purpose of the present study was to quantify the first-pass uptake and oxidation of glucose by the splanchnic tissues (intestine and liver) in human neonates.


METHODS
Eight preterm infants [birth weight ( +/- SD): 1.19 +/- 0.22 kg, gestational age: 29 +/- 1 wk] were studied while they received 2 different enteral intakes (A: 40% enteral, 60% parenteral, total glucose intake = 7.5 +/- 0.5 mg. kg(-1). min(-1), and B: 100% enteral, total glucose intake = 7.8 +/- 0.4 mg. kg(-1). min(-1)). Splanchnic and whole-body glucose kinetics were measured by use of dual-tracer techniques.


RESULTS
During both feeding periods, approximately one-third of dietary glucose intake was utilized during the first pass by the splanchnic tissues. More than three-quarters of this utilized glucose was oxidized in both periods (79 +/- 36% with A and 84 +/- 45% with B). Whole-body glucose oxidation was substantial under both circumstances: 72 +/- 5% and 77% +/- 6% of the glucose flux was oxidized during partial (A) and full (B) enteral feeding, respectively.


CONCLUSIONS
Approximately one-third of dietary glucose is utilized during the first pass by the splanchnic tissues, irrespective of the dietary intake. Most of the utilized glucose is used for energy generation.
van der Schoor
Sophie R D
SR
Erasmus MC-Sophia Children's Hospital, Department of Pediatrics, Dr Molewaterplein 60, 3015 GJ Rotterdam, Netherlands.
Stoll
Barbara
B
Wattimena
Darcos L
DL
Büller
Hans A
HA
Tibboel
Dick
D
Burrin
Douglas G
DG
van Goudoever
Johannes B
JB
D000222:Adaptation, Physiological; D002247:Carbon Isotopes; D004750:Enteral Nutrition; D005260:Female; D005947:Glucose / Q000008:administration & dosage / Q000378:metabolism / Q000493:pharmacokinetics*; D006801:Humans; D007225:Infant Food; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007234:Infant, Premature / Q000378:metabolism*; D007408:Intestinal Absorption; D008297:Male; D013058:Mass Spectrometry; D010084:Oxidation-Reduction; D010288:Parenteral Nutrition; D013152:Splanchnic Circulation / Q000502:physiology*
D002247:Carbon Isotopes; D005947:Glucose