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Perinatal factors influencing hepatic glucose-6-phosphatase enzyme activity
R Hume1, A McGeechan, A Burchell
1Department of Obstetrics and Gynecology, Tayside Institute of Child Health, Ninewells Hospital and Medical School, University of Dundee, Scotland. r.hume@dundee.ac.uk
Insights
Perinatal factors like bacterial infections and ritodrine exposure impact liver glucose production in preterm infants. These factors influence hepatic glucose-6-phosphatase activity, crucial for preventing hypoglycemia after birth.
Area of Science:
- Neonatal physiology
- Biochemistry
- Perinatal medicine
Background:
- Preterm infants often experience hypoglycemia post-discharge due to low liver glucose production.
- Hepatic glucose-6-phosphatase (G6Pase) activity, essential for glucose release, is typically reduced in neonates.
Purpose of the Study:
- To identify perinatal factors influencing hepatic glucose-6-phosphatase enzyme activity in preterm infants.
- Understanding these factors can help mitigate neonatal hypoglycemia.
Main Methods:
- Stepwise multiple regression analysis was used.
- Correlated maximum velocity (Vmax) of hepatic microsomal G6Pase with clinical data from 45 preterm infants.
Main Results:
- Maternal bacterial swabs, hyperkalemia, ritodrine exposure, and delivery mode were significant factors (p ≤ 0.0005).
- Positive early infant bacterial cultures showed the strongest correlation with G6Pase activity.
Conclusions:
- Perinatal events and clinical interventions significantly modulate G6Pase enzyme systems.
- These modulations are critical for successful adaptation to extrauterine life in preterm infants.
Background:
At discharge from neonatal units, many preterm infants are vulnerable to preprandial hypoglycemia due to insufficient liver glucose production. In most preterm infants, hepatic glucose-6-phosphatase activity (the terminal step of liver glucose production) remains abnormally low postnatally.
Objective:
To determine what perinatal factors are associated with changes in hepatic glucose-6-phosphatase enzyme activity.
Study Design:
The maximum velocity (Vmax) of the hepatic microsomal glucose-6-phosphatase enzyme, as the dependent variable, was correlated by stepwise multiple regression analysis with clinical data from a consecutive series of 45 preterm infants from a level 3 neonatal unit.
Results:
Significant factors (p < or = 0.0005) were the presence of pathogenic bacteria isolated from maternal high vaginal swabs (p < or = 0.0000), hyperkalemia regimen, duration of prenatal exposure to ritodrine, and delivery mode. Further analysis revealed that the highest correlation was with positive early post-delivery infant bacterial cultures.
Conclusion:
Perinatal events and clinical interventions modulate key enzyme systems necessary for human adaptation to extrauterine life.