Kliegman R M
Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, Ohio 44106.
Am J Physiol. 1989 Mar;256(3 Pt 1):E380-5. doi: 10.1152/ajpendo.1989.256.3.E380.
Maternal nutritional deprivation resulted in reduced fetal weight at term gestation (251 +/- 7 vs. 277 +/- 7 g, P less than 0.01) in newborn dogs. Growth-retarded pups developed lower blood glucose levels after 3, 6, and 9 h of neonatal fasting, reduced plasma levels of free fatty acids (FFA) at 9 and 24 h, and lower ketone bodies at 24 h compared with age-matched newborn control pups. Systemic rates of palmitate and alanine turnover were not affected, but systemic glucose turnover was reduced for 3-9 h after birth. The rate of alanine incorporation into glucose from 3 to 9 h was also reduced in growth-retarded pups compared with timed controls. Paradoxically, the rate of incorporation of palmitate into triglycerides was augmented in the smaller growth-retarded pups. Hepatic glycogen content was reduced at every time in the study among growth-retarded pups, whereas the rates of glycogenolysis between birth and 24 h were equivalent in the two pup groups. In contrast, hepatic triglyceride levels were augmented throughout the study in pups with growth retardation. Maternal starvation and lower glucose levels resulted in a lower hepatic energy charge, and augmented cytoplasmic and mitochondrial NAD-to-NADH ratios in intrauterine growth-retarded pups. These data suggest that intrauterine growth retardation in dogs results in fasting neonatal hypoglycemia that is due in part to reduced systemic glucose production. We speculate that reduced rates of gluconeogenesis from alanine and reduced oxidation of alternate fuels such as FFA contribute to hypoglycemia. FFA recycling to triglyceride synthesis rather than oxidative pathways may contribute to the observed reduction of circulating glucose levels.
母体营养缺乏导致新生犬足月妊娠时出生体重降低(251±7克对277±7克,P<0.01)。与年龄匹配的新生对照幼犬相比,生长发育迟缓的幼犬在出生后禁食3、6和9小时后血糖水平较低,在9小时和24小时时游离脂肪酸(FFA)血浆水平降低,在24小时时酮体水平较低。棕榈酸和丙氨酸的全身周转率未受影响,但出生后3至9小时全身葡萄糖周转率降低。与定时对照相比,生长发育迟缓的幼犬在3至9小时内丙氨酸掺入葡萄糖的速率也降低。矛盾的是,在较小的生长发育迟缓的幼犬中,棕榈酸掺入甘油三酯的速率增加。在整个研究过程中,生长发育迟缓的幼犬肝脏糖原含量均降低,而两组幼犬在出生至24小时之间的糖原分解速率相当。相比之下,在整个研究过程中,生长发育迟缓的幼犬肝脏甘油三酯水平均升高。母体饥饿和较低的葡萄糖水平导致宫内生长发育迟缓幼犬的肝脏能量电荷降低,细胞质和线粒体中NAD与NADH的比率升高。这些数据表明,犬的宫内生长发育迟缓会导致新生幼犬空腹低血糖,部分原因是全身葡萄糖生成减少。我们推测,丙氨酸糖异生速率降低以及FFA等替代燃料的氧化减少导致了低血糖。FFA循环用于甘油三酯合成而非氧化途径可能导致了循环葡萄糖水平的降低。