Trindade C, Huang M, Hulman S, Reef S, Kliegman R
Department of Pediatrics, Case Western Reserve University Rainbow Babies and Childrens Hospital, Cleveland, Ohio 44106.
Pediatr Res. 1988 May;23(5):474-9. doi: 10.1203/00006450-198805000-00008.
There is a paucity of information on the significance of insulin on neonatal cerebral glucose metabolism. The effect of insulin on neonatal cerebral glucose uptake and cerebral cortical metabolic intermediates was investigated with the euglycemic hyperinsulinemic clamp in unanesthetized beagles during the first day of life. Insulin was infused at various rates to sustain an elevated steady state plasma insulin concentration in individual pups. Furthermore, blood glucose and 2-deoxyglucose levels were also maintained ("clamped") in a steady state by infusion of glucose and 2-deoxy-[14C]-glucose. Mean (+/- SD) plasma insulin levels were 20 +/- 12 and 2971 +/- 3386 (33-14330) microU/ml in control and hyperinsulinemic pups. Blood glucose concentration was 4.43 +/- 2.64 mM during basal periods and 4.54 +/- 2.87 mM during the clamp period in study pups. Basal fasting glucose utilization in study pups was 43.9 +/- 24 mumol/kg/min and increased to 60.9 +/- 35.2 mumol/kg/min (p less than 0.001) during hyperinsulinemia. Immediately after the euglycemic hyperinsulinemic clamp or fasting in control pups, the cerebral cortex was frozen to the temperature of liquid nitrogen. No differences were noted for any cerebral cortical intermediate between the two pup groups. In addition, there was no relationship between the cerebral intermediates concentration when analyzed as a function of plasma insulin levels. The uptake of cerebral 2-deoxyglucose was analyzed as a function of plasma insulin concentration (120-6900 microU/ml). Brain tissue demonstrated a positive linear relationship for 2-deoxyglucose uptake as a function of plasma insulin concentration.(ABSTRACT TRUNCATED AT 250 WORDS)
关于胰岛素对新生儿脑葡萄糖代谢的意义,目前信息匮乏。在出生第一天,通过对未麻醉的比格犬进行正常血糖高胰岛素钳夹试验,研究了胰岛素对新生儿脑葡萄糖摄取及大脑皮质代谢中间产物的影响。以不同速率输注胰岛素,使各幼崽维持稳定的高血浆胰岛素浓度。此外,通过输注葡萄糖和2-脱氧-[14C]-葡萄糖,将血糖和2-脱氧葡萄糖水平也维持在稳定状态(“钳夹”)。对照幼崽和高胰岛素血症幼崽的平均(±标准差)血浆胰岛素水平分别为20±12和2971±3386(33 - 14330)微单位/毫升。研究幼崽在基础期血糖浓度为4.43±2.64毫摩尔/升,钳夹期为4.54±2.87毫摩尔/升。研究幼崽基础空腹葡萄糖利用率为43.9±24微摩尔/千克/分钟,高胰岛素血症时增至60.9±35.2微摩尔/千克/分钟(p<0.001)。在正常血糖高胰岛素钳夹试验后或对照幼崽禁食后,立即将大脑皮质冷冻至液氮温度。两组幼崽大脑皮质的任何中间产物均未发现差异。此外,将大脑中间产物浓度作为血浆胰岛素水平的函数进行分析时,二者无相关性。将大脑2-脱氧葡萄糖摄取量作为血浆胰岛素浓度(120 - 6900微单位/毫升)的函数进行分析。脑组织显示2-脱氧葡萄糖摄取量与血浆胰岛素浓度呈正线性关系。(摘要截短至250字)