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Gluconeogenesis continues in premature infants receiving total parenteral nutrition

Shaji K Chacko1, Agneta L Sunehag

  • 1Department of Pediatrics, Baylor College of Medicine, Houston, Texas 77030, USA.

Archives of Disease in Childhood. Fetal and Neonatal Edition
|August 5, 2010
PubMed

Insights

In preterm infants on total parenteral nutrition (TPN), gluconeogenesis is sustained and accounts for most residual glucose production, even when glucose infusion exceeds normal rates. This process is independent of glucose infusion rates or blood glucose levels.

Area of Science:

  • Neonatal physiology
  • Metabolic studies
  • Parenteral nutrition

Background:

  • Preterm infants often receive total parenteral nutrition (TPN) with high glucose loads.
  • Understanding glucose metabolism in these vulnerable infants is crucial for optimizing nutritional support.

Purpose of the Study:

  • To quantify the contribution of gluconeogenesis to overall glucose production in preterm infants receiving TPN.
  • To investigate the impact of high glucose infusion rates on gluconeogenesis.

Main Methods:

  • Stable isotope-gas chromatography-mass spectrometry techniques were employed.
  • Deuterated water and the Chacko and Landau methods were used to measure glucose appearance and gluconeogenesis rates.
  • Eight preterm infants (26.5±0.5 weeks gestation) on routine TPN were studied.

Main Results:

  • Gluconeogenesis accounted for a significant portion of residual glucose production (68-73%) in preterm infants on TPN.
  • The rate of gluconeogenesis was substantial, with values around 1.3 mg/kg per min.
  • Neither the glucose infusion rate nor blood glucose concentration affected gluconeogenesis or glycogenolysis.

Conclusions:

  • Gluconeogenesis is an active and significant pathway for glucose production in preterm infants receiving TPN, even at supra-physiological glucose infusion rates.
  • The rate of gluconeogenesis is not influenced by the amount of glucose infused or the resulting blood glucose levels in this population.
Abstract

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