Document Detail


Gluconeogenesis continues in premature infants receiving total parenteral nutrition.
MedLine Citation:
PMID:  20682577     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the contribution of total gluconeogenesis to glucose production in preterm infants receiving total parenteral nutrition (TPN) providing glucose exceeding normal infant glucose turnover rates.
STUDY DESIGN: Eight infants (0.955±0.066 kg, 26.5±0.5 weeks, 4±1 days) were studied while receiving routine TPN. The glucose appearance rate (the sum of rates of glucose infusion and residual glucose production) and gluconeogenesis were measured by stable isotope-gas chromatography-mass spectrometry techniques using deuterated water and applying the Chacko and Landau methods.
RESULTS: Blood glucose ranged from 5.2 to 14.3 mmol/l (94-257 mg/dl) and the glucose infusion rate from 7.4 to 11.4 mg/kg per min, thus exceeding the normal glucose production rates (GPR) of newborn infants in most of the babies. The glucose appearance rate was 12.4±0.6 and GPR 2.1±0.3 mg/kg per min. Gluconeogenesis as a fraction of the glucose appearance rate was 11.2±1.1% (Chacko) and 10.5±1.2% (Landau) (NS) and the rate of gluconeogenesis was 1.35±0.15 mg/kg per min (Chacko) and 1.29±0.14 mg/kg per min (Landau) (NS). Gluconeogenesis accounted for 73±11% and 68±10 (NS) of the GPR for the two methods, respectively. Gluconeogenesis and glycogenolysis were not affected by the total glucose infusion rate, glucose concentration, gestational age or birth weight. Glucose concentration correlated with the total glucose infusion rate and gestational age (combined R(2)=0.79, p=0.02).
CONCLUSIONS: Gluconeogenesis is sustained in preterm infants receiving routine TPN providing glucose at rates exceeding normal infant glucose turnover rates and accounts for the major part of residual glucose production. Gluconeogenesis is not affected by the glucose infusion rate or blood glucose concentration.
Authors:
Shaji K Chacko; Agneta L Sunehag
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2010-08-03
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  95     ISSN:  1468-2052     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-27     Completed Date:  2010-12-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  England    
Other Details:
Languages:  eng     Pagination:  F413-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, Baylor College of Medicine, Houston, Texas 77030, USA.
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MeSH Terms
Descriptor/Qualifier:
Birth Weight / physiology
Blood Glucose / metabolism
Female
Gas Chromatography-Mass Spectrometry / methods
Gestational Age
Gluconeogenesis / physiology*
Humans
Infant Nutritional Physiological Phenomena / physiology*
Infant, Newborn
Infant, Premature / blood,  physiology*
Infant, Very Low Birth Weight / blood,  physiology
Male
Parenteral Nutrition, Total / methods*
Grant Support
ID/Acronym/Agency:
M01-RR-001888/RR/NCRR NIH HHS; R01 HD 37857/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Blood Glucose

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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