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Splanchnic bed metabolism of glucose in preterm neonates

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 lif...

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Published in:The American journal of clinical nutrition 2004-05, Vol.79 (5), p.831-837
Main Authors: Schoor, S.R.D. van der, Stoll, B, Wattimena, D.L, Buller, H.A, Tibboel, D, Burrin, D.G, Goudoever, J.B. van
Format: Article
Language:English
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Summary: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 (average +/- 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.
ISSN:0002-9165
1938-3207
DOI:10.1093/ajcn/79.5.831