Perinatal Research Center, Department of Pediatrics, University of Colorado School of Medicine , Aurora, Colorado.
Am J Physiol Endocrinol Metab. 2018 Dec 1;315(6):E1143-E1153. doi: 10.1152/ajpendo.00128.2018. Epub 2018 Sep 11.
Overcoming impaired growth in an intrauterine growth-restricted (IUGR) fetus has potential to improve neonatal morbidity, long-term growth, and metabolic health outcomes. The extent to which fetal anabolic capacity persists as the IUGR condition progresses is not known. We subjected fetal sheep to chronic placental insufficiency and tested whether prolonged amino acid infusion would increase protein accretion in these IUGR fetuses. IUGR fetal sheep were infused for 10 days with either mixed amino acids providing ~2 g·kg·day (IUGR-AA) or saline (IUGR-Sal) during late gestation. At the end of the infusion, fetal plasma leucine, isoleucine, lysine, methionine, and arginine concentrations were higher in the IUGR-AA than IUGR-Sal group ( P < 0.05). Fetal plasma glucose, oxygen, insulin, IGF-1, cortisol, and norepinephrine concentrations were similar between IUGR groups, but glucagon concentrations were fourfold higher in the IUGR-AA group ( P < 0.05). Net umbilical amino acid uptake rate did not differ between IUGR groups; thus the total amino acid delivery rate (net umbilical amino acid uptake + infusion rate) was higher in the IUGR-AA than IUGR-Sal group (30 ± 4 vs. 19 ± 1 μmol·kg·min, P < 0.05). Net umbilical glucose, lactate, and oxygen uptake rates were similar between IUGR groups. Fetal leucine oxidation rate, measured using a leucine tracer, was higher in the IUGR-AA than IUGR-Sal group (2.5 ± 0.3 vs. 1.7 ± 0.3 μmol·kg·min, P < 0.05). Fetal protein accretion rate was not statistically different between the IUGR groups (1.6 ± 0.4 and 0.8 ± 0.3 μmol·kg·min in IUGR-AA and IUGR-Sal, respectively) due to variability in response to amino acids. Prolonged amino acid infusion into IUGR fetal sheep increased leucine oxidation rates with variable anabolic response.
在宫内生长受限(IUGR)胎儿中,增强生长潜力有可能改善新生儿发病率、长期生长和代谢健康结局。目前尚不清楚随着 IUGR 病情的发展,胎儿的合成代谢能力能在多大程度上持续。我们对胎儿绵羊进行了慢性胎盘功能不全处理,并测试了在妊娠晚期长时间输注氨基酸是否会增加这些 IUGR 胎儿的蛋白质积累。在输注期间,IUGR 胎儿绵羊连续 10 天输注混合氨基酸(提供约 2 g·kg·day)或生理盐水(IUGR-Sal)。输注结束时,IUGR-AA 组胎儿血浆亮氨酸、异亮氨酸、赖氨酸、蛋氨酸和精氨酸浓度高于 IUGR-Sal 组(P < 0.05)。两组 IUGR 胎儿的血糖、氧、胰岛素、IGF-1、皮质醇和去甲肾上腺素浓度相似,但 IUGR-AA 组胰高血糖素浓度高 4 倍(P < 0.05)。两组 IUGR 胎儿的脐氨基酸净摄取率无差异;因此,IUGR-AA 组的总氨基酸输送率(脐氨基酸净摄取率+输注率)高于 IUGR-Sal 组(30±4 比 19±1 μmol·kg·min,P < 0.05)。两组 IUGR 胎儿的脐葡萄糖、乳酸和氧摄取率相似。用亮氨酸示踪剂测量的胎儿亮氨酸氧化率在 IUGR-AA 组高于 IUGR-Sal 组(2.5±0.3 比 1.7±0.3 μmol·kg·min,P < 0.05)。由于对氨基酸的反应存在差异,IUGR 两组胎儿的蛋白质积累率无统计学差异(IUGR-AA 和 IUGR-Sal 分别为 1.6±0.4 和 0.8±0.3 μmol·kg·min)。将氨基酸长时间输注到 IUGR 胎儿绵羊中会增加亮氨酸氧化率,但合成代谢反应存在差异。