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宫内生长迟缓早产儿生长激素治疗期间的亮氨酸和葡萄糖动力学

Leucine and glucose kinetics during growth hormone treatment in intrauterine growth-retarded preterm infants.

作者信息

Van Toledo-Eppinga L, Houdijk M C, Delemarre-Van De Waal H A, Jakobs C, Lafeber H N

机构信息

Department of Pediatrics, Free University Hospital, Amsterdam, The Netherlands.

出版信息

Am J Physiol. 1996 Mar;270(3 Pt 1):E451-5. doi: 10.1152/ajpendo.1996.270.3.E451.

Abstract

The present study was performed with the objective to investigate the possible effects of recombinant human growth hormone (rhGH) supplementation on protein and glucose metabolism during the early postnatal period in seven intrauterine growth-retarded (IUGR) preterm infants. Eight infants were studied as controls. The metabolic rate was measured by indirect calorimetry, and whole body protein and glucose kinetics were measured using constant-rate infusions of [1-13C] leucine and [U-13C]glucose during continuous adequate oral feeding. Energy expenditure was similar in both groups. In the rhGH-treated group of infants, leucine turnover (470 +/- 76 vs. 409 +/- micromol/ kg/day), leucine used for protein synthesis (402 +/- 72 vs. 337 +/- 36 micromol /kg/day), and leucine derived from protein breakdown (365 +/- 71 vs. 304 +/- 41 micromol/kg/day) were increased. However, net leucine balance was not increased (37 +/- 17 vs. 34 +/- 13 micromol/kg/day). The total rate of appearance of glucose was 10.1 +/- 1.2 vs. 10.0 +/- 1.3 mg/kg/min. We suggest that immediate postnatal treatment with rhGH is not effective in stimulating protein gain and has no effect on glucose kinetics in IUGR preterm infants.

摘要

本研究旨在调查补充重组人生长激素(rhGH)对7名宫内生长受限(IUGR)早产儿出生后早期蛋白质和葡萄糖代谢的可能影响。选取8名婴儿作为对照。通过间接测热法测量代谢率,并在持续充足口服喂养期间,使用[1-13C]亮氨酸和[U-13C]葡萄糖的恒速输注来测量全身蛋白质和葡萄糖动力学。两组的能量消耗相似。在接受rhGH治疗的婴儿组中,亮氨酸周转率(470±76对409±微摩尔/千克/天)、用于蛋白质合成的亮氨酸(402±72对337±36微摩尔/千克/天)以及源自蛋白质分解的亮氨酸(365±71对304±41微摩尔/千克/天)均增加。然而,亮氨酸净平衡并未增加(37±17对34±13微摩尔/千克/天)。葡萄糖的总出现率为10.1±1.2对10.0±1.3毫克/千克/分钟。我们认为,出生后立即用rhGH治疗对刺激IUGR早产儿的蛋白质增加无效,且对葡萄糖动力学无影响。

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