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Glucose-alanine relationship in normal human pregnancy.
S C Kalhan1, C A Gilfillan, K Y Tserng
1Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland Metropolitan General Hospital, OH 44109.
Metabolism: Clinical and Experimental
|February 1, 1988
Summary
Pregnancy reduces the conversion of alanine to glucose, indicating attenuated gluconeogenesis. This metabolic shift is linked to higher insulin levels, not changes in alanine availability.
Area of Science:
- Metabolic research
- Human physiology
- Endocrinology
Background:
- Understanding glucose-alanine metabolism is crucial for maternal and fetal health during pregnancy.
- Pregnancy involves significant metabolic adaptations to support fetal growth.
Purpose of the Study:
- To quantify the glucose-alanine relationship in late-term normal human pregnancy.
- To compare alanine turnover and its incorporation into glucose between pregnant and nonpregnant women.
Main Methods:
- Infusion of stable isotope tracers (L-[2,3-13C2]Alanine and D[6,6-2H2]glucose).
- Measurement of isotopic enrichment using gas chromatography-mass spectrometry.
- Estimation of CO2 production via indirect calorimetry and tracer data.
Main Results:
- Alanine turnover rates were similar in pregnant and nonpregnant women.
- Alanine incorporation into glucose was significantly lower in pregnant women (23.5% vs 30.8%).
- Lactate derived from alanine was lower in pregnancy (20% vs 28%), with increased plasma insulin.
Conclusions:
- Gluconeogenesis from alanine is attenuated during human pregnancy.
- This attenuation is likely due to intrahepatic mechanisms, possibly insulin-mediated, rather than altered alanine flux.
- Metabolic adaptations in pregnancy favor glucose conservation.