Hulman S E, Kliegman R M
Department of Pediatrics, Case Western Reserve University, Rainbow Babies and Children's Hospital, Cleveland, OH 44106.
Pediatr Res. 1989 Feb;25(2):219-23. doi: 10.1203/00006450-198902000-00028.
The developmental response to the euglycemic hyperinsulinemic clamp was assessed among newborn and adult beagles to investigate neonatal insulin resistance. Both neonatal dogs and adults were clamped at euglycemic blood glucose concentrations while receiving insulin at a rate of 3.75, 15, 30, 60, 75 or 100 mU/kg/min to generate a dose-response curve. Blood glucose levels, plasma insulin concentrations and glucose turnover rates during the basal preclamp fasting period were similar in pups and adult dogs. During the clamp period, blood glucose levels were equivalent to the preclamp period whereas plasma insulin concentrations increased. Total glucose utilization increased from 28.7 +/- 18 to a plateau level of 114 +/- 52.3 mumol/kg/min in adult dogs and from 30.9 +/- 10.9 to 53.9 +/- 28.9 mumol/kg/min in newborn dogs. Suppression of endogenous glucose production during euglycemic hyperinsulinemia was close to 100% among adult dogs, whereas in the newborn pups, endogenous glucose production was suppressed 80%. To determine if the newborn was unable to increase glucose uptake because of a saturation effect on glucose utilization independent of insulin, another group of adult and newborn dogs received a hyperglycemic hyperinsulinemic clamp. In response to the hyperglycemic clamp, adults demonstrated an increase of glucose utilization to 261 +/- 83, and newborn dogs increased utilization to 227 +/- 76 mumol/kg/min.(ABSTRACT TRUNCATED AT 250 WORDS)
在新生和成年比格犬中评估了对正常血糖高胰岛素钳夹的发育反应,以研究新生儿胰岛素抵抗。在维持正常血糖浓度的同时,分别以3.75、15、30、60、75或100 mU/kg/min的速率给新生犬和成年犬注射胰岛素,以生成剂量反应曲线。幼犬和成年犬在基础钳夹前禁食期的血糖水平、血浆胰岛素浓度和葡萄糖周转率相似。在钳夹期间,血糖水平与钳夹前时期相当,而血浆胰岛素浓度增加。成年犬的总葡萄糖利用率从28.7±18增加到平稳水平114±52.3 μmol/kg/min,新生犬则从30.9±10.9增加到53.9±28.9 μmol/kg/min。在成年犬中,正常血糖高胰岛素血症期间内源性葡萄糖生成的抑制接近100%,而在新生幼犬中,内源性葡萄糖生成被抑制了80%。为了确定新生犬是否由于对葡萄糖利用的饱和效应而无法增加葡萄糖摄取(与胰岛素无关),另一组成年犬和新生犬接受了高血糖高胰岛素钳夹。对高血糖钳夹的反应中,成年犬的葡萄糖利用率增加到261±83,新生犬的利用率增加到227±76 μmol/kg/min。(摘要截短于250字)