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Effect of hydrocortisone on intravenous glucose tolerance in small-for-gestational-age infants
Insights
Hydrocortisone hemisuccinate reduces glucose uptake in small-for-gestational-age infants. This corticoid administration impairs peripheral glucose utilization, independent of insulin secretion, affecting glucose tolerance in newborns.
Area of Science:
- Neonatal Physiology
- Endocrinology
- Metabolic Research
Background:
- Small-for-gestational-age (SGA) infants may exhibit altered glucose metabolism.
- The impact of corticosteroids on neonatal glucose tolerance requires further elucidation.
Purpose of the Study:
- To investigate the effects of hydrocortisone hemisuccinate on intravenous glucose tolerance in SGA newborns.
- To compare glucose metabolism in SGA infants with and without hydrocortisone administration.
Main Methods:
- Intravenous glucose tolerance tests were performed on eight SGA infants and seven control infants.
- Hydrocortisone hemisuccinate (10 mg/kg) was administered to the SGA group.
- Plasma glucose and insulin levels were measured at various time points post-glucose injection.
Main Results:
- Hydrocortisone administration significantly reduced the rate of glucose disappearance in SGA infants (0.92 +/- 0.27% min vs. 1.24 +/- 0.31% min in controls, p < 0.01).
- Plasma glucose levels were significantly higher in the hydrocortisone group at 30, 45, and 60 minutes post-injection (p < 0.05).
- Hydrocortisone increased plasma insulin concentrations in SGA infants, suggesting impaired peripheral glucose uptake independent of insulin secretion.
Conclusions:
- Corticosteroids, such as hydrocortisone hemisuccinate, induce reduced peripheral glucose uptake in newborn infants.
- This effect is independent of insulin secretion and contributes to impaired glucose tolerance in SGA neonates.
- Findings highlight the metabolic impact of corticosteroids on neonatal glucose homeostasis.
Abstract:
The effects of hydrocortisone (H) hemisuccinate (10 mg/kg) on intravenous glucose tolerance (1 g/kg) was studied in eight full term small-for-gestational-age (SGA) infants and compared to seven control infants at mean age of 41 h. After H, the rate of glucose disappearance was (mean +/- SD) 0.92 +/- 0.27 vs 1.24 +/- 0.31% min in controls (p less than 0.01). Glucose space was similar after H: 449 +/- 62 ml/kg and in the control group 468 +/- 75 ml/kg. At 5 and 15 min, although higher in the H group, mean plasma glucose was not significantly different. The difference became significant at 30 min (t = 2.00; p = 0.05), 45 (t = 2.298; p less than 0.05) and 60 min (t = 2.48; p less than 0.02). Plasma insulin concentration did not change after glucose injection in the control group. After H administration, plasma insulin increased: the basal median value was less than 5 mU/ml (range less than 5-18) and at 60 min it rose to 30 mU/ml (range 7.5-89). These data suggest that in newborn infants corticoids induce a reduced peripheral uptake of glucose independent of insulin secretion.