EVALUATION OF THE RELATION BETWEEN TPN COMPOSITION AND HYPERGLYCEMIA AND THE

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。接受TPN治疗的早产儿经常会出现高血糖。据报道，发病率为50%-80%。然而，这些研究大多有10-15年的历史。高血糖与早产程度、葡萄糖输注率、败血症等疾病有关。它还与渗透性利尿、尿糖丢失、高渗透压和脑出血有关。关于1)上述因素与高血糖之间的真实关系；2)与高血糖有关的真实风险；3)“可接受的”高血糖的阈值；4)胰岛素等治疗的效果；5)胰岛素治疗期间低血糖的发生率，存在争议。在过去的5年里，早产儿的营养治疗已经发生了变化，特别是现在在出生的第一天就引入了肠外氨基酸和脂肪，输液率迅速提高。因此，作为我们优化这些小婴儿营养治疗的努力的一部分，评估营养和其他因素对高血糖发展的影响以及不同程度的高血糖的长期影响是重要的。

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. Hyperglycemia is frequently occurring in very premature infants receiving TPN. Incidence figures of 50-80% have been reported. Most of these studies are, however, 10-15 years old. Hyperglycemia has been associated with the degree of prematurity, infusion rates of glucose, illness e.g. sepsis. It has also been associated with osmotic diuresis, urinary gulcose loss, hyperosmolarity and cerebral bleedings. There is controversy regarding 1) the true relations between the above factors and hyperglycemia; 2) the real risks associated with hyperglycemia; 3) threshold for "acceptable" hyperglycemia; 4) effects of treatment such as insulin; 5) the incidence of hypoglycemia during insulin treatment. The nutritional treatment of very premature infants has changed over the past 5 years, specifically, parenteral amino acids and lipids are now introduced within the first days of birth and the infusion rates are increased rapidly. Thus, as a part of our attempts to optimize the nutritional treatment of these small infants, it is important to evaluate the impact of nutrition and other factors on the development of hyperglycemia, and also the long term effects of different degrees of hyperglycemia.