Hyperaminoacidemia due to the accumulation of gluconeogenic amino acid precursors in hypoglycemic small-for-gestational age infants.

The postnatal (3 to 12 hours) plasma amino acid patterns of normal full-term, nonhypoglycemic, and hypoglycemic small-for-gestational age infants were compared. Seventeen amino acid were separated by automatic column chromatography. It was found that hypoglycemia in SGA newborn infants was associated with a marked increase in total serum amino acid concentrations. This hyperaminoacidemia, which was mainly due to the increase in concentrations of alanine, glycine, proline, and valine, apparently reflected a decreased heapatic gluconeogenic capacity. A significant inverse correlation was observed between concentration of blood glucose and the accumulation of gluconeogenic amino acids. The proportionate accumulation of alanine, glycine, proline, and valine suggests a closely interrelated production and release of these amino acids from the peripheral pools. It is concluded that the changes in concentrations of plasma amino acids occurring in hypoglycemic SGA infants can be helpful in understanding the relative contribution of individual amino acids to gluconeogenesis in the human infant.