Glucose production and gluconeogenesis are negatively related to body weight in mechanically ventilated, very low birth weight neonates

Tamir Keshen, Ronna Miller, Farook Jahoor, Tom Jaksic, Peter J. Reeds

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

The regulation of gluconeogenesis by low birth weight infants remains poorly delineated. To investigate this, 15 5-d-old infants (26-31-wk gestational age, 795-1485-g body weight), were infused i.v. for 4 h with uniformly labeled [U-13C]glucose (5 mg/kg/min) as the sole source of glucose. Intralipid (3 mg/kg/min) was provided, but no amino acids were given. Blood samples were taken immediately before and after 4 h of tracer infusion. The isotopic enrichments of plasma glucose and alanine were measured by selected ion monitoring gas chromatography mass spectrometry. Glucose production rates were calculated from the isotopic dilution of plasma [U-13C]glucose and the glucose infusion rate. Gluconeogenesis was estimated from the relative isotopic enrichments of [M + 3]- and [M + 6]-glucose, using the isotopic enrichment of plasma [U-13C]alanine, to define the isotopic dilution of the 3-carbon pool, and previously published equations to calculate the isotopic dilution of hepatic oxaloacetate. Glucose production (15 ± 9 μmol/kg/min) was negatively related to body weight (r = -0.67; p < 0.05) and the ratio of the isotopic enrichments of [13C3]alanine;[13C6]glucose (0.27 ± 0.07) was positively related to body weight (r = 0.74; p < 0.025). Both relationships were exponential. Gluconeogenesis (via pyruvate) accounted for 72 ± 28% of glucose production, and gluconeogenesis per unit body weight was negatively and exponentially (r = -0.82; p < 0.005) related to body weight. These results demonstrate that neonates whose birth weights are less than 1200 g have a particularly high glucose production rate secondary to enhanced gluconeogenesis. We speculate that these results reflect a high weight-specific glucose demand that is met by up-regulation of gluconeogenesis.

Original languageEnglish (US)
Pages (from-to)132-138
Number of pages7
JournalPediatric Research
Volume41
Issue number1
StatePublished - Jan 1997

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Very Low Birth Weight Infant
Gluconeogenesis
Body Weight
Newborn Infant
Glucose
Alanine
Oxaloacetic Acid
Low Birth Weight Infant
Pyruvic Acid
Birth Weight
Gas Chromatography-Mass Spectrometry
Gestational Age
Up-Regulation
Carbon

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Glucose production and gluconeogenesis are negatively related to body weight in mechanically ventilated, very low birth weight neonates. / Keshen, Tamir; Miller, Ronna; Jahoor, Farook; Jaksic, Tom; Reeds, Peter J.

In: Pediatric Research, Vol. 41, No. 1, 01.1997, p. 132-138.

Research output: Contribution to journalArticle

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