|Vander Schoor, Sophie|
|Burrin, Douglas - Doug|
|Van Goudoever, Johannes|
Submitted to: American Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 10/15/2003
Publication Date: 10/1/2003
Citation: Vander Schoor, S., Stoll, B., Wattimena, D.L., Buller, H.A., Tibboel, D., Burrin, D.G., Van Goudoever, J. 2004. Splanchnic bed metabolism of glucose in the preterm neonates. American Journal of Clinical Nutrition. 79:831-837. Interpretive Summary: The rate of energy needs in premature neonates is significantly higher than adult humans. A major source of dietary energy for neonates is the simple sugar, glucose. Studies in adults humans suggest that most of the glucose ingested is absorbed into the blood to provide energy for body tissues, such as the skeletal muscle and brain. However, in infants, the gut may use a significant amount of the dietary glucose and thereby reduce the energy supply for critical tissues, namely the brain. The aim of the study was to determine the amount of dietary glucose used by the liver and gut tissues in eight premature infants. The metabolism of dietary glucose was determined using a unique chemical form of glucose, called a stable isotope, which allowed us to distinguish between dietary and endogenously produced glucose. The results indicate that approximately one-third of dietary glucose is used by the liver and gut tissues. In addition, most of the glucose used by liver and gut tissues was used to meet the energy needs. The study suggests that the liver and gut tissues have a significant impact on the amount of dietary glucose available for peripheral body tissues, such as muscle and brain.
Technical Abstract: BACKGROUND: Glucose is a major oxidative substrate for intestinal energy generation in neonatal animals; however, few data in preterm infants are available. Early administration of enteral nutrition, including glucose, may be an effective strategy to support intestinal adaptation to extrauterine life in preterm neonates. OBJECTIVE: The purpose of the present study was to quantify the first-pass uptake and oxidation of glucose by the splanchnic tissues (intestine and liver) in human neonates. DESIGN: Eight preterm infants [birth weight (mean +/- SD): 1.19 +/- 0.22 kg, gestational age: 29 +/- 1 wk] were studied while they received 2 different enteral intakes (A: 40% enteral, 60% parenteral, total glucose intake = 7.5 +/- 0.5 mg. kg(-1). min(-1), and B: 100% enteral, total glucose intake = 7.8 +/- 0.4 mg. kg(-1). min(-1)). Splanchnic and whole-body glucose kinetics were measured by use of dual-tracer techniques. RESULTS: During both feeding periods, approximately one-third of dietary glucose intake was utilized during the first pass by the splanchnic tissues. More than three-quarters of this utilized glucose was oxidized in both periods (79 +/- 36% with A and 84 +/- 45% with B). Whole-body glucose oxidation was substantial under both circumstances: 72 +/- 5% and 77% +/- 6% of the glucose flux was oxidized during partial (A) and full (B) enteral feeding, respectively. CONCLUSIONS: Approximately one-third of dietary glucose is utilized during the first pass by the splanchnic tissues, irrespective of the dietary intake. Most of the utilized glucose is used for energy generation.