IMPACT OF REDUCED GLUCOSE INFUSION RATE AND INSULIN INFUSION, RESPECTIVELY, O

分别降低葡萄糖输注速度和胰岛素输注的影响，O

• 批准号: 8166664
• 负责人: Agneta Lisbeth Sunehag
• 金额: $ 0.07万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-12-01 至 2010-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8166664
• 关键词: Affect; Amino Acids; Birth Weight; Blood; Blood Glucose; Body Weight; Clinical; Computer Retrieval of Information on Scientific Projects Database; Energy Intake; Enteral Feeding; Extremely Low Birth Weight Infant; Funding; Gestational Age; Gluconeogenesis; Glucose; Grant; Hyperglycemia; Incidence; Infant; Infusion procedures; Institution; Insulin; Intravenous; Learning; Lipids; Metabolic; Newborn Infant; Parenteral Nutrition; Patients; Physiological; Physiology; Plasma; Production; Protein Biosynthesis; Research; Research Personnel; Resources; Risk; Severities; Source; Supplementation; Techniques; Total Parenteral Nutrition; United States National Institutes of Health; design; glucose metabolism; protein metabolism; response; stable isotope

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Extremely low birth weight (ELBW) newborns (birth weight <1000g), usually require Total Parenteral Nutrition (TPN) during the course of their illness and until their ability to tolerate enteral feeds is well established. These infants are at risk of disturbed glucose metabolism and inadequate energy supplementation. They have a very high incidence of hyperglycemia (50-80%). Usually, these high blood glucose values are being treated with reduction of the glucose infusion rate and/or with intravenous insulin, depending on the severity of the hyperglycemia and the patient''s clinical picture. We do not know whether gluconeogenesis is affected by the changes in glucose and insulin concentrations resulting from reduced glucose infusion rates or by a fixed insulin infusion. the purpose of this study is to determine the effect of reducing the glucose infusion rate to correspond to half the normal glucose turn over rate and of a fixed insulin infusion, on glucose and protein metabolism in ELBW infnats. It is important for us to learn about the physiology of glucose metabolism in these very small infants for it will enable us to design an adequate parenteral nutrition that renders these infants normoglycemic while providing a sufficient energy intake. 1. Rates of gluconeogenesis do not change in response to a decrease in blood levels of glucose and insulin, resulting from a decrease in the glucose infusion rate to 3mg/kg/min. 2. A fixed infusion of insulin sufficient to achieve a plasma insulin concentration in the high physiologic range (-80-100uU/ml) will: a. Not acutely suppress rates of gluconeogenesis b. Increase glucose utilization regardless of body weight, gestational age and clinical status, but increasing the glucose utilization will be proportional to body weight c. Increase protein synthesis The purpose of this study is to determine the metabolic effects of changes in glucose and insulin concentration resulting from reducing the infusion rate of glucose to correspond to half normal glucose turnover (while maintaining the infusion rates of parenteral lipids and amino acids unchanged) and from a fixed insulin infusion on rates of glucose utilization and production in extremely low birth weight infants. This will be performed using Stable Isotope-GCMS techniques. This will allow us to determine the metabolic effects of different glucose infusion rates and plasma insulin levels in sick newborn infants.

该副本是利用众多研究子项目之一 由NIH/NCRR资助的中心赠款提供的资源。子弹和 调查员（PI）可能已经从其他NIH来源获得了主要资金， 因此可以在其他清晰的条目中代表。列出的机构是 对于中心，这不一定是调查员的机构。 出生体重（ELBW）的新生儿（出生体重<1000g）通常需要在疾病过程中总肠胃外营养（TPN），直到他们耐受肠内饲料的能力得到很好的确定。 这些婴儿有葡萄糖代谢障碍和补充能量不足的风险。 它们的高血糖发病率很高（50-80％）。 通常，这些高血糖值通过降低葡萄糖输注率和/或静脉内胰岛素的降低来治疗，具体取决于高血糖的严重程度和患者的临床情况。 我们不知道糖异生是否受葡萄糖和胰岛素浓度的变化影响，导致葡萄糖输注率降低或受固定的胰岛素输注。 这项研究的目的是确定将葡萄糖输注率降低到一半的葡萄糖翻转速率和固定胰岛素输注，对ELBW Infnats中葡萄糖和蛋白质代谢的影响。 对我们而言，重要的是要了解这些很小的婴儿葡萄糖代谢的生理学，因为它将使我们能够设计出足够的肠胃外营养，从而在提供足够的能量摄入量的同时，使这些婴儿正常。 1。糖异生速率不会因葡萄糖和胰岛素的血液水平降低而变化，这是由于葡萄糖输注率降低至3mg/kg/min。 2。足以在高生理范围内实现血浆胰岛素浓度的固定输注（-80-100UU/mL）将： 一个。 并非急性抑制糖异生的速率b。 不管体重，胎龄和临床状况如何，增加葡萄糖利用率，但增加葡萄糖的利用率将与体重c成正比。增加蛋白质合成 这项研究的目的是确定由于降低葡萄糖的输注速率而导致的葡萄糖和胰岛素浓度变化的代谢影响，以对应于一半正常的葡萄糖更换（同时保持肠胃脂脂质和氨基酸的输注率不变），以及固定的胰岛素输注对葡萄糖的生产速率的固定胰岛素输注率极低的生产量和生产量极低。 这将使用稳定的同位素-GCMS技术进行。 这将使我们能够确定病人新生婴儿不同葡萄糖输注率和血浆胰岛素水平的代谢作用。