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Catabolic effect in premature infants with early dexamethasone treatment
1Department of Pediatrics, China Medical College Hospital, Taichung, Taiwan.
Insights
Dexamethasone therapy in premature infants significantly increased amino acid levels and urinary 3-methylhistidine (3MH), indicating heightened protein catabolism. These findings suggest potential risks associated with early dexamethasone use.
Area of Science:
- Neonatal Medicine
- Biochemistry
- Pharmacology
Background:
- Bronchopulmonary dysplasia (BPD) is a common complication in premature infants.
- Dexamethasone is used to prevent BPD, but its effects on protein metabolism are not fully understood.
Purpose of the Study:
- To evaluate the catabolic effects of early dexamethasone therapy on protein metabolism in premature infants.
- To assess changes in amino acid concentrations and urinary 3-methylhistidine (3MH) levels.
Main Methods:
- A double-blind, controlled study involving 28 premature infants.
- Infants received either dexamethasone (0.5 mg/kg/day i.v.) or a saline control.
- Amino acid analysis of blood samples and urinary 3MH measurements were performed.
Main Results:
- Dexamethasone-treated infants showed a significant increase in amino acid concentrations, including alanine, glutamine, citrulline, ornithine, and cystine.
- The 3-methylhistidine (3MH) to creatinine ratio in urine increased in the dexamethasone group.
- These changes suggest an increase in protein catabolism.
Conclusions:
- Early dexamethasone therapy in premature infants appears to increase protein catabolism.
- Metabolic monitoring is crucial for infants receiving dexamethasone treatment.
Abstract:
To evaluate the catabolic effects of dexamethasone therapy on protein metabolism, amino acid concentrations and urinary 3-methylhistidine (3MH) were measured in 28 premature infants who were included in a double-blind controlled study using early dexamethasone therapy in the prevention of bronchopulmonary dysplasia. Fifteen infants received dexamethasone (0.5 mg/kg/day i.v.) and 13 infants received normal saline as control. Heparinized venous blood samples for amino acid analysis were obtained before the study and again at day 5 after starting the study. Urinary 3MH was measured on days 1, 3, 5, 7, 14, 21, and 28 of treatment. A substantial increase in amino acid concentrations was observed in infants receiving dexamethasone. Alanine, glutamine, citrulline, ornithine and cystine concentrations increased twofold or more. The 3MH:creatinine ratio was increased in the treated group. These metabolic effects were most likely due to an increase in protein catabolism.