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Red cell glycolytic intermediates and adenosine triphosphate in preterm infants on the first day of life
Insights
Red blood cell metabolism in preterm infants shows higher glucose-6-phosphate and ATP but lower 2,3-diphosphoglycerate (2,3-DPG) compared to term infants. This suggests increased glycolytic rate in younger red blood cells.
Area of Science:
- Neonatal Physiology
- Red Blood Cell Metabolism
- Biochemistry
Background:
- Preterm infants have unique physiological characteristics.
- Red blood cell (RBC) metabolism is crucial for oxygen delivery.
- Understanding metabolic differences in preterm infants is vital for neonatal care.
Purpose of the Study:
- To investigate red cell glycolytic intermediates and ATP in preterm infants.
- To compare metabolic profiles between preterm and term infants.
- To assess the impact of gestational age on RBC metabolism.
Main Methods:
- Evaluated RBC glycolytic intermediates and ATP in 47 preterm infants (28-36 wk gestation).
- Grouped infants by gestational age (28-30, 31-33, 34-36 wk).
- Compared results with previously obtained data from term infants.
Main Results:
- Preterm infants had higher glucose-6-phosphate, triose phosphates, and ATP than term infants.
- RBC 2,3-diphosphoglycerate (2,3-DPG) was significantly decreased in preterm infants, lowest at 28-30 wk.
- Elevated 3-phosphoglycerate in preterm infants suggested increased glycolytic flux and altered 2,3-DPG bypass activity.
- Two infants with acidosis showed markedly decreased 2,3-DPG and ATP, indicating a phosphofructokinase step cross-over.
Conclusions:
- Preterm infants exhibit distinct RBC metabolic patterns compared to term infants.
- Younger RBC populations in preterm infants show increased glycolytic rates.
- Acidosis in preterm infants significantly impairs RBC energy metabolism and 2,3-DPG production.
Abstract:
Red cell glycolytic intermediates and ATP were evaluated in 47 appropriate for gestational age preterm infants on the 1st day of life who were divided into three groups on the basis of gestational age: 28-30, 31-33, and 34-36 wk. The results were compared to those previously obtained in term infants. The concentrations of glucose-6-phosphate, total triose phosphates, and ATP were significantly higher than in term infants but appeared to be appropriately elevated for the young mean age of the red cell population. The concentration of red cell 2,3-diphosphoglycerate (2,3-DPG) was significantly decreased when compared to term infants and was lowest at 28-30 wk gestation. The content of red cell 3-phosphoglycerate was increased in term infants and was inappropriately elevated for the age of the red cell population at 28-30 wk gestation. This pattern of glycolytic intermediates was suggestive of a young red cell population metabolizing at an increased glycolytic rate with increased flow through the phosphoglycerate kinase step rather than the 2,3-DPG bypass in "normal" preterm infants. Two preterm infants of 28-30 wk gestation with low red cell intracellular pH were also evaluated and had markedly decreased concentrations of red cell 2,3-DPG and ATP and all phosphorylated intermediates distal to the phosphofructokinase reaction, indicative of a cross-over at the phosphofructokinase step secondary to acidosis.(ABSTRACT TRUNCATED AT 250 WORDS)