Related Experiment Videos
Leucine kinetics during simultaneously administered insulin and dexamethasone in preterm infants with severe lung
R H van Beek1, L J Zimmermann, J G Vergunst van Keulen
1Department of Pediatrics, Ignatius Hospital Breda, 4800 RK Breda, The Netherlands.
Insights
Insulin did not prevent the catabolic effects of dexamethasone in preterm infants with chronic lung disease. Leucine metabolism remained unchanged, but weight gain decreased during treatment.
Area of Science:
- Biochemistry
- Neonatology
- Pediatric Endocrinology
Background:
- Dexamethasone is known to cause catabolic effects in preterm infants with chronic lung disease.
- Insulin is an anabolic hormone that may counteract these effects.
Purpose of the Study:
- To investigate if insulin administration can prevent the catabolic effects of dexamethasone in very-low-birth-weight infants with chronic lung disease.
- To assess the impact of insulin on leucine metabolism during dexamethasone treatment.
Main Methods:
- A study involving 11 very-low-birth-weight infants receiving dexamethasone treatment.
- Leucine metabolism was measured before and on days 2, 4, and 7 of dexamethasone administration.
- Insulin was administered intravenously at doses of 0.5 or 1.0 IU/kg/d during the first 4 days of dexamethasone treatment.
Main Results:
- Leucine turnover and breakdown showed no significant changes during insulin and dexamethasone administration.
- Weight gain rates were significantly lower during the first week of dexamethasone treatment compared to other periods.
- The observed decrease in weight gain was not reversed by insulin administration.
Conclusions:
- Insulin administration did not alter leucine kinetics in very-low-birth-weight infants receiving dexamethasone.
- The catabolic effects of dexamethasone, indicated by reduced weight gain, were not mitigated by concurrent insulin therapy.
- Further research may be needed to explore alternative strategies for managing dexamethasone-induced catabolism in this population.
Abstract:
The objective of this study was to determine whether insulin administration would prevent the well-documented catabolic effect of dexamethasone given to preterm infants with chronic lung disease. We studied leucine metabolism in 11 very-low-birth-weight infants before dexamethasone treatment and on d 2, 4, and 7 thereafter. During the first 4 d of dexamethasone, insulin was administered i.v. at a dose of 0.5 (n = 7) or 1.0 (n = 5) IU/kg/d. Leucine turnover was not significantly different between d 0 (337 +/- 41.3 micromol leucine/kg/h), d 2 (288 +/- 27.2 micromol leucine/kg/h), d 4 (302 +/- 22.1 micromol leucine/kg/h), and d 7 (321 +/- 21.2 micromol leucine/kg/h), and neither was leucine breakdown (272 +/- 21.9 micromol leucine/kg/h on d 0, 225 +/- 21.5 micromol leucine/kg/h on d 2, 231 +/- 21 micromol leucine/kg/h on d 4, and 242 +/- 17.6 micromol leucine/kg/h on d 7). Weight gain rates were significantly lower during the first week of dexamethasone treatment compared with the week before treatment or the second and third week. We conclude that during insulin and corticosteroid administration in very-low-birth-weight infants, no changes were observed in leucine kinetics in contrast to previous studies. The decrease in weight gain was not reversed.