Ogata E S, Collins J W, Finley S
Department of Pediatrics, Northwestern University Medical School, Northwestern Memorial Hospital, Chicago, IL.
Metabolism. 1988 Jul;37(7):649-55. doi: 10.1016/0026-0495(88)90084-4.
Fetal hyperinsulinemia is a well-known correlate of accelerated fetal growth; the consequences of fetal hyperinsulinemia upon fetal and neonatal glucoregulation are less well understood. We injected rat fetuses of a litter on day 18 of gestation with either 5 units of long acting insulin (I) or 154 mmol/L NaCl. Twelve hours after injection, the wet and dry mass of total body and liver of I fetuses significantly exceeded that of controls. At birth (day 21.5), newborn I pups weighed 5.86 +/- .08 g, and controls, 5.48 +/- .05 g, (P less than .001). On day 18, within one hour of injection, fetal plasma insulin concentrations were significantly elevated and remained so for 24 hours. Mothers of I fetuses had significant elevations of plasma insulin at 1, 3, and 6 hours, and they developed transient hypoglycemia. Plasma glucose concentrations in I fetuses were significantly diminished at 1, 3, and 6 hours and then achieved control levels by 12 hours. Fetal hypoglycemia resulted from an apparent direct effect of insulin upon fetal tissue and from the maternal hypoglycemia. Hypoglycemic I fetuses demonstrated a sluggish alpha-cell response; they failed to increase plasma glucagon one hour after insulin injection. Values were significantly increased three hours after injection. At birth, I pups became hypoglycemic relative to controls. This was, in part, due to their significantly elevated plasma insulin concentrations at 120 and 240 minutes (120 minutes, 43.8 +/- 8 v 17.5 +/- 6 microU/mL, P less than .001). Plasma glucagon was significantly increased in I pups at 240 minutes.(ABSTRACT TRUNCATED AT 250 WORDS)
胎儿高胰岛素血症是胎儿生长加速的一个已知相关因素;胎儿高胰岛素血症对胎儿和新生儿糖调节的影响则了解较少。我们在妊娠第18天给一窝大鼠胎儿注射5单位长效胰岛素(I组)或154 mmol/L氯化钠。注射后12小时,I组胎儿的全身和肝脏湿重及干重显著超过对照组。出生时(第21.5天),I组新生幼崽体重为5.86±0.08 g,对照组为5.48±0.05 g(P<0.001)。在第18天,注射后1小时内,胎儿血浆胰岛素浓度显著升高,并持续24小时。I组胎儿的母亲在1、3和6小时时血浆胰岛素显著升高,且出现短暂低血糖。I组胎儿的血浆葡萄糖浓度在1、3和6小时时显著降低,然后在12小时时达到对照水平。胎儿低血糖是由胰岛素对胎儿组织的明显直接作用以及母体低血糖导致的。低血糖的I组胎儿表现出α细胞反应迟缓;胰岛素注射1小时后,它们未能增加血浆胰高血糖素。注射3小时后该值显著升高。出生时,I组幼崽相对于对照组出现低血糖。这部分是由于它们在120和240分钟时血浆胰岛素浓度显著升高(120分钟时,43.8±8对17.5±6 μU/mL,P<0.001)。I组幼崽在240分钟时血浆胰高血糖素显著升高。(摘要截短于250字)