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Published on: November 11, 2021
Energy expenditure, lipolysis, and glucose production in preterm infants treated with theophylline
C R Fjeld1, F S Cole, D M Bier
1Washington University School of Medicine, Department of Pediatrics, St. Louis, Missouri 63110.
Insights
Theophylline treatment in preterm infants did not significantly alter lipolysis, gluconeogenesis, or energy expenditure. This study investigated the metabolic effects of theophylline in premature infants with pulmonary disease.
Area of Science:
- Neonatal Physiology
- Pharmacology
- Metabolic Research
Background:
- Theophylline is used to treat pulmonary issues and apnea in preterm infants.
- Its potential alpha- and beta-receptor mechanisms suggest effects on metabolism.
- Investigating these metabolic effects is crucial for understanding theophylline's role in neonatal care.
Purpose of the Study:
- To test if theophylline increases lipolysis, gluconeogenesis from glycerol, and energy expenditure in preterm infants.
- To compare these metabolic parameters between theophylline-treated and control groups.
Main Methods:
- Utilized stable isotope tracers ([2-13C]glycerol and [6,6-3H2] glucose) to measure lipolysis and hepatic glucose production.
- Employed the 2H2(18)O method to assess body water and energy expenditure.
- Compared measurements between a theophylline-treated group (T) and a control group (C) of preterm infants.
Main Results:
- No significant differences were observed in mean daily energy expenditure between the theophylline (65 +/- 22 kcal/kg/d) and control (59 +/- 5 kcal/kg/d) groups.
- Glucose production rates were also similar between groups (40.5 +/- 4.3 mumol/kg/min in T vs. 37.6 +/- 4.8 mumol/kg/min in C).
- Body water volumes, indicative of fat content, were comparable in both groups.
Conclusions:
- Theophylline administration did not significantly impact lipolysis, gluconeogenesis from glycerol, or overall energy expenditure in this cohort of preterm infants.
- The study's findings suggest that the tested metabolic pathways are not significantly affected by therapeutic theophylline doses in preterm infants.
- Further research may be needed to explore other potential mechanisms or effects of theophylline in this population.
Abstract:
Theophylline is administered to preterm infants with pulmonary disease to improve pulmonary function and reduce apneic episodes. Because it potentially mediates both alpha- and beta-receptor-effector mechanisms, we tested the hypothesis that it increases lipolysis, gluconeogenesis from glycerol, and energy expenditure in 16 preterm infants, eight of whom were treated therapeutically with theophylline for apnea of prematurity (T) and eight of whom were controls (C). Mean +/- SD postnatal ages were 4.8 +/- 1.9 wk (T) and 2.4 +/- 0.9 wk (C) (p < 0.01). Corrected gestational ages were 35 +/- 1.6 wk (T) and 34 +/- 0.5 wk (C) (p = NS). Body weights were 1.69 +/- 0.13 kg (T) and 1.70 +/- 0.23 kg (C) (p = NS). All infants were clinically stable, breathing room air, fed enterally, and receiving no diuretics, steroids, or antibiotics. Lipolysis, hepatic glucose production, and gluconeogenesis from glycerol were measured using [2-13C]glycerol and [6,6-3H2] glucose tracers. Body water and energy expenditure were measured by the 2H2(18)O method. Body water volumes were 68.5 +/- 3.4% body weight (T) and 70.2 +/- 3.4% (C) (p = NS), suggesting fat was 10-13% of body weight in both groups. Mean daily energy expenditure was 65 +/- 22 kcal/kg body weight/d (T) versus 59 +/- 5 kcal/kg body weight/d (C) (p = NS). Between 4 and 6 h after a feeding, glucose production rates were 40.5 +/- 4.3 mumol/kg/min (T) and 37.6 +/- 4.8 mumol/kg/min (C) (p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)
