title: Endogenous glucose production from infancy to adulthood: a non-linear regression model.
abstract: OBJECTIVE
  To construct a regression model for endogenous glucose production (EGP) as a function of age, and compare this with glucose supplementation using commonly used dextrose-based saline solutions at fluid maintenance rate in children.
  
  
  METHODS
  A model was constructed based on EGP data, as quantified by [6,6-(2)H2] glucose dilution after fasting overnight during normoglycaemia, in 40 healthy subjects aged 2.5-54.3 years old. The data were analysed using non-linear regression modelling with a 1-phase exponential decay curve fit. This model was compared to the amount of glucose provided with 2.5% or 5% dextrose-based saline solutions infused at fluid maintenance rate.
  
  
  RESULTS
  Non-linear regression analysis of the EGP data yielded the following regression model: EGP (mg/kg/min) = 6.50 × 2.72(-0.145 × age (y))+1.93. Glucose supplementation at fluid maintenance rate with a 5% dextrose-based saline solution ranged from 46% at age 1 year to 55% at age 18 years of the glucose required to preclude the need for EGP. With a 2.5% dextrose-based solution, these percentages are 23% at age 1 year to 27% at age 18 years.
  
  
  CONCLUSIONS
  we present an accurate non-linear regression model for EGP as a function of age. With standard dextrose-based saline solutions infused at fluid maintenance rate, only approximately 50% or less of EGP is provided. With prolonged infusion of these solutions, the deficit between exogenous glucose supplementation and EGP may induce a catabolic state and may ultimately lead to hypoglycaemia, especially in younger children.
authors.affiliation: Department of Paediatrics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Hidde H
authors.identifier: http://orcid.org/0000-0003-1276-0931
authors.initials: HH
authors.lastname: Huidekoper
authors.affiliation: Departement of Clinical Chemistry, Laboratory for Endocrinology and Radiochemistry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Mariëtte T
authors.initials: MT
authors.lastname: Ackermans
authors.affiliation: Departement of Clinical Chemistry, Laboratory for Endocrinology and Radiochemistry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: An F C
authors.initials: AF
authors.lastname: Ruiter
authors.affiliation: Department of Endocrinology and Metabolism, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Hans P
authors.initials: HP
authors.lastname: Sauerwein
authors.affiliation: Department of Paediatrics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Frits A
authors.initials: FA
authors.lastname: Wijburg
mesh_terms: D000293:Adolescent; D000328:Adult; D000375:Aging / Q000502:physiology*; D001786:Blood Glucose / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D005440:Fluid Therapy; D005947:Glucose / Q000008:administration & dosage; D005951:Glucose Tolerance Test; D006801:Humans; D007223:Infant; D007333:Insulin Resistance / Q000502:physiology; D016014:Linear Models; D008099:Liver / Q000378:metabolism; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D011865:Radioisotope Dilution Technique; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D005947:Glucose
keywords: General Paediatrics; Metabolic; Paediatric Practice