GLUCOSE METABOLISM IN NEWBORN INFANTS WITH CONGENITAL HEART DISEASE

患有先天性心脏病的新生儿的葡萄糖代谢

• 批准号: 7605873
• 负责人: Agneta Lisbeth Sunehag
• 金额: $ 0.04万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-02-15 至 2007-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7605873
• 关键词: Affect; Amino Acids; Blood Glucose; Computer Retrieval of Information on Scientific Projects Database; Disease; Energy Intake; Enteral Feeding; Funding; Gluconeogenesis; Glucose; Grant; Heart Diseases; Hyperglycemia; Hypoglycemia; Infant; Infusion procedures; Institution; Learning; Life; Lipids; Metabolic; Newborn Infant; Oats; Parenteral Nutrition; Personal Satisfaction; Physiology; Protein Biosynthesis; Purpose; Rate; Research; Research Personnel; Resources; Risk; Source; Techniques; Total Parenteral Nutrition; Treatment Protocols; United States National Institutes of Health; abstracting; congenital heart disorder; day; glucose metabolism; glucose production; neonate; prevent; protein metabolism; 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. ABSTRACT Sick neonates, including those with congenital heart disease, usually require Total Parenteral Nutrition (TPN) during their first several days of life until their ability to tolerate enteral feeds is well established. These infnats, as well as those born prematurely, are at risk of disturbed glucose metabolism and inadequate energy supplejentation. In an effort to prevent hypoglycemia and to provide a sufficient energy intake, some of these neonates are routinely receiving glucose at rates about twice their normal glucose turn over rate (: 6 mg/kg/min.) This regimen results in a frequently occurrence of hyperglycemia, particularly in premature and sick infants. We do not know how changing the glucose infusion rate affects the glucose metabolism and the blood glucose levels innewborns with congenitalheart disease. The purpos of this project is to determine the effects of different glucose infusion rates on glucose, lipid, and protein metabolism innewborn infants with congenital heart disease. It is important for us to learn about the physiology of glucose metabolism in these sick neonates to enable us to formulate an adequate parenteral nutrition that renders these infants normoglycemic and provide them with a sufficient energy intake. HYPOTHESIS Hyperglycemia is more likely to occur during routine TPN (usually providing glucose at rates corresponding about twice the normal glucose turnover rate) than during a TPN providing glucose at 6 mg/kg/min (normal glucose turnover rate). Newborn infants with congenital heart disease are able to maintain normoglycemia during a 6mg/kg/min glucose infusion rate (while maintaining the infusion rates of parenteral lipids and amino acids unchanged). Glucose production, particularly gluconeogenesis, is not completely suppressed in infants with contential heart disease while receiving a routine TPN providing glucose at twice normal turnover rate. Whole-body protein synthesis is reduced in sick infants receiving TPN providing at 6mg/kg/min. SPECIFIC AIMS The purpose of this study is to determine the effects of routine TPN (providing glucose oat about twice normal turnover rates), and of reducing the infusion rate of glucose to correspond to the normal glucose turnover (while maintaining the infusion rates of paenteral lipids and amino acids unchanged) on glucose, lipid and protein metabolism in infants with congenital heart disease using established Stable Isotope-GCMS techniques. This will allow us to determine the metabolic effects of glucose infusion rate in sick newborn infants with congenital heart disease.

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 摘要 患病的新生儿，包括患有先天性心脏病的新生儿，通常在他们出生的头几天需要完全肠外营养(TPN)，直到他们对肠道喂养的耐受性得到很好的确立。这些婴儿，以及那些早产的婴儿，面临着葡萄糖代谢紊乱和能量供应不足的风险。为了防止低血糖和提供足够的能量摄入，这些新生儿中的一些常规接受葡萄糖的速度大约是正常葡萄糖周转率的两倍(：6毫克/公斤/分钟)。这种疗法会导致频繁发生高血糖，特别是在早产儿和生病的婴儿中。我们不知道改变葡萄糖输注速度如何影响先天性心脏病新生儿的葡萄糖代谢和血糖水平。本项目的目的是确定不同的葡萄糖输注速率对先天性心脏病新生儿的葡萄糖、脂肪和蛋白质代谢的影响。对我们来说，重要的是了解这些患病新生儿的葡萄糖代谢生理学，使我们能够制定足够的肠外营养，使这些婴儿保持正常血糖，并为他们提供足够的能量摄入。 假设 常规TPN(通常以相当于正常葡萄糖周转率两倍的速率提供葡萄糖)比以6 mg/kg/min(正常葡萄糖周转率)提供葡萄糖的TPN更容易发生高血糖。 患有先天性心脏病的新生儿能够在6 mg/kg/min葡萄糖输注速率下保持正常血糖(同时保持肠外脂肪和氨基酸的输注速率不变)。 患有先天性心脏病的婴儿在接受常规的TPN时，葡萄糖的产生，特别是糖异生，并没有完全受到抑制，TPN提供的葡萄糖是正常周转率的两倍。 服用6 mg/kg/min TPN的患病婴儿全身蛋白质合成减少。 具体目标 本研究的目的是利用已建立的稳定的同位素GCMS技术，确定常规TPN(提供大约两倍正常周转速率的葡萄糖燕麦片)和降低葡萄糖输注速率以与正常葡萄糖周转相对应(同时保持肠外脂肪和氨基酸的输注速率不变)对先天性心脏病婴儿糖、脂和蛋白质代谢的影响。这将使我们能够确定葡萄糖输注速率对患有先天性心脏病的新生儿的代谢影响。