Ogata E S, Paul R I, Finley S L
Department of Pediatrics, Northwestern University Medical School, Northwestern Memorial Hospital, Chicago, Illinois.
Pediatr Res. 1987 Oct;22(4):432-7. doi: 10.1203/00006450-198710000-00014.
We rendered pregnant rats chronically hyperinsulinemic to determine the effect of reduced maternal metabolic fuel availability on fetal growth and development. We implanted osmotically driven insulin loaded minipumps on day 14 (term 21.5 days) in pregnant rats. This significantly increased maternal plasma concentrations of insulin and reduced glucose from day 15 until term. From day 17 until birth, fetal growth was significantly less for hyperinsulinemic mothers (term birth weight 4.53 +/- 0.07 versus 5.64 +/- 0.06 g, p less than 0.001). In fetuses of hyperinsulinemic mothers plasma glucose and insulin concentrations were significantly reduced while glucagon concentrations were increased. Total plasma amino acids were significantly reduced in maternal rats and their fetuses from days 17 to 19 while arteriovenous blood gas tensions and pH did not differ between fetuses of hyperinsulinemic and control mothers. Small for gestational age newborn pups of hyperinsulinemic mothers were hypoglycemic for the first 240 min of life as a result of limited hepatic glycogen stores and a delay in the normally expected induction of hepatic cytosolic phosphoenolpyruvate carboxykinase. This occurred despite significant increases in neonatal plasma glucagon concentrations. These data indicate that limitation of maternal glucose and amino acids with normal placental gaseous exchange retards fetal growth, limits hepatic glycogen deposition, and delays neonatal phosphoenolpyruvate carboxykinase induction. Limited fetal insulin secretion resulting from diminished maternal fuel availability may have also been a factor in retarding growth. The delay in phosphoenolpyruvate carboxykinase induction despite enhanced glucagon secretion during fetal and neonatal life suggests a specific "resistance" to this hormone in the rat growth retarded by limited metabolic fuel availability.
我们使怀孕大鼠长期处于高胰岛素血症状态,以确定母体代谢燃料供应减少对胎儿生长发育的影响。在怀孕大鼠妊娠第14天(足月为21.5天)植入渗透驱动的胰岛素微型泵。这显著提高了母体血浆胰岛素浓度,并从第15天直至足月降低了血糖水平。从第17天直至出生,高胰岛素血症母亲所生胎儿的生长明显较慢(足月出生体重为4.53±0.07克,而对照组为5.64±0.06克,p<0.001)。高胰岛素血症母亲所生胎儿的血浆葡萄糖和胰岛素浓度显著降低,而胰高血糖素浓度升高。从第17天至19天,母体大鼠及其胎儿的血浆总氨基酸显著减少,而高胰岛素血症母亲和对照母亲所生胎儿的动静脉血气张力和pH值并无差异。高胰岛素血症母亲所生的小于胎龄新生儿在出生后的头240分钟内出现低血糖,这是由于肝糖原储备有限以及肝脏胞质磷酸烯醇式丙酮酸羧激酶的正常诱导延迟所致。尽管新生儿血浆胰高血糖素浓度显著升高,但仍出现这种情况。这些数据表明,在胎盘气体交换正常的情况下,母体葡萄糖和氨基酸的限制会阻碍胎儿生长,限制肝糖原沉积,并延迟新生儿磷酸烯醇式丙酮酸羧激酶的诱导。母体燃料供应减少导致胎儿胰岛素分泌受限可能也是生长迟缓的一个因素。尽管在胎儿期和新生儿期胰高血糖素分泌增强,但磷酸烯醇式丙酮酸羧激酶诱导延迟,这表明在因代谢燃料供应有限而生长迟缓的大鼠中,对这种激素存在特定的“抵抗”。