Cohen W R, Piasecki G J, Cohn H E, Susa J B, Jackson B T
Department of Obstetrics and Gynecology, Albert Einstein College of Medicine, Bronx, New York.
Am J Physiol. 1991 Jul;261(1 Pt 1):E95-102. doi: 10.1152/ajpendo.1991.261.1.E95.
Interrelations of sympathoadrenal function and changes in glucose and insulin homeostasis were studied in chronically cannulated late gestation fetal sheep. Catecholamine secretory rates (based on direct adrenal sampling) and plasma concentrations were determined in the fetus during 2 h of insulin-induced hypoglycemia, during a period of hypoxemia, and during hyperinsulinemia per se (i.e., without hypoglycemia). Fetal insulin infusion (5-10 mU.kg-1.min-1) resulted in hypoglycemia and a significant rise in secretion of epinephrine but not of norepinephrine. By contrast, fetal hypoxemia caused a prompt and significant increase in adrenal secretion of both norepinephrine and epinephrine. Changes in peripheral plasma catecholamine levels were usually, but not always, qualitatively similar to those in adrenal secretion; the latter was a far more sensitive indicator of adrenal function. Hyperinsulinemia per se caused no change in adrenal secretory rates or plasma concentrations of catecholamines. Nevertheless, insulin infusion caused a fetal tachycardia even in the absence of hypoglycemia and hypoxemia, suggesting either a direct effect on the heart or stimulation of sympathetic nerves.
在长期插管的妊娠晚期胎羊中研究了交感肾上腺功能与葡萄糖和胰岛素稳态变化之间的相互关系。在胰岛素诱导的低血糖2小时期间、低氧血症期间以及高胰岛素血症本身(即无低血糖)期间,测定胎儿的儿茶酚胺分泌率(基于直接肾上腺采样)和血浆浓度。胎儿胰岛素输注(5 - 10 mU·kg⁻¹·min⁻¹)导致低血糖和肾上腺素分泌显著增加,但去甲肾上腺素分泌未增加。相比之下,胎儿低氧血症导致肾上腺去甲肾上腺素和肾上腺素分泌迅速且显著增加。外周血浆儿茶酚胺水平的变化通常(但并非总是)在性质上与肾上腺分泌的变化相似;后者是肾上腺功能更敏感的指标。高胰岛素血症本身并未引起肾上腺分泌率或儿茶酚胺血浆浓度的变化。然而,即使在无低血糖和低氧血症的情况下,胰岛素输注也会导致胎儿心动过速,这表明胰岛素要么对心脏有直接作用,要么刺激交感神经。