Abstract
In order to quantify the energetic role of ketone bodies (KB):β-hydroxybutyrate (BOB) and acetoacetate (AcAc), in the neonatal period, 6 infants born at terme were studied within their first 2 days of life, 4-5 hours after being fed. Plasma glucose was 58 ± 5 mg/dl, FFA 810 ± 206 μM, blood AcAc 296 ± 112 μM and BOB 486 ± 67 μM. The kinetics of KB metabolism were measured using the in vivo dilution of the nonradioactive tracer [4,4,4-2H3] BOB and a gas chromatography-mass spectrometry micromethod validated in fasting rats. The rate of KB production was 17.3 ± 1.4 μmol kg/min., with an almost equal value for KB utilization (values reached in adults only after 7-21 days fasting). KB metabolic clearance rate was 2.8 ± 6.6 ml kg/min. (⩽ 12 ml kg/min in fasted adults with similar utilization rates). From FFA values, we estimated FFA turnover (J.Cl.Inv., 1982 70): 14 ± 2 μmol kg/min., which was correlated with KB production (p < 0.01) so that ∼ 31± 3% of FFA were utilized for ketogenesis (vs 25-35 % in fasted adults). We conclude that (1) the rates of neonatal KB production are similar or superior to those in older children and adults (2) the proportion of FFA converted to KB by the neonatal liver is within the same range as in older subjects (3) the uptake of KB relative to circulating KB concentration is accelerated, indicating an increased capacity of the ketone-consuming neonatal tissues to extract blood KB, mostly at low concentrations.
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Bougnères, P. 90 MATURITY OF KETONE BODY PRODUCTION AND UTILIZATION IN THE HUMAN NEONATE. Pediatr Res 19, 618 (1985). https://doi.org/10.1203/00006450-198506000-00110
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DOI: https://doi.org/10.1203/00006450-198506000-00110