Abstract
Glucose production in premature neonates depends upon available gluconeogenic substrates and intact enzymatic and hormonal systems. To determine whether lipid alone or in concert with amino acids alters glucoregulation, we determined the glycemic response from intravenous lipid in 8 premature infants (BW 1226 ± 100 g, GA 28.6±1.4 wks). At 4±2 days of age, we administered either Intralipid (L) alone (.25 g/kg over 20 min followed by .5 gm/kg/hr × 100 min) or an identical Intralipid dose plus amino acids (Aminosyn, .5 gm/kg over 4 hrs) (LA). All infants received concurrent glucose at 5-6 mg/kg/min throughout the study. Free fatty acid concentrations increased within 10 min of infusion and peak values were equivalent in L and LA infants (4345 vs 3100 μ Eq/L). LA infants demonstrated a brisk glycemic response compared to L infants (23±3 vs 7±2% increase at 10 min). In addition, LA infusion resulted in a far greater increase at 150 min compared to L (65±11 vs 30±7%). Preliminary data in infants receiving A alone suggest a limited glycemic response relative to L and LA infants. Insulin responded appropriately in L and LA infants increasing from 10 to 75 μU/ml in response to increasing glucose, while glucagon demonstrated no consistent pattern in either group. L infusion results in a mild glycemic response in premature infants, while LA administration more promptly increases glucose. These data suggest that lipids enhance gluconeogenesis from amino acids in premature infants.
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Savich, R., Finley, S., Bussey, M. et al. 1255 LIPID INFUSION ENHANCES GLUCONEOGENESIS FROM AMINO ACIDS IN PREMATURE INFANTS. Pediatr Res 19, 320 (1985). https://doi.org/10.1203/00006450-198504000-01285
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DOI: https://doi.org/10.1203/00006450-198504000-01285