Abstract
Gluconeogenesis and ketogenesis are regarded as important for preserving blood glucose homeostasis in human newborns. We have studied simultaneously ketone body (KB) and glucose turnover rates in six preterm newborn infants (gestational age: 33.0 ± 3.6 wk; birth wt: 1937 ± 861 g) 28.7 ± 19.3 h postnatally, during glucose infusion with a rate of 20.5 ± 5.1 μmol/kg.min. Kinetics were measured using [1, 2, 3, 4 13C4] acetoacetate, D-(-)-3-OH-[4, 4, 4 2H3]butyric acid and [6, 6 2H2] glucose. The enrichment of tracers in plasma was analysed by gas chromatography/mass spectrometry. Results: Total KB production rate was 1.90 ± 0.78 μmol/kg.min. The rates of interconversion between acetoacetate and 3-OH-butyrate ranged widely. The whole body glucose turnover and the glucose production rate (GPR) were 30.3 ± 6.8 μmol/kg.min and 9.8 ± 5.8 μmol/kg.min, respectively. In two infants the glucose infusion rate was doubled stepwise during the study and the turnover studies were repeated. Both KB turnover and GPR were reduced. Conclusion: In preterm newborn in the first days after birth the turnover of KB is suppressed, the plasma KB concentration is low, and the contribution to total energy metabolism is negligible during administration of glucose. The regulation of ketogenesis seems to be functioning in these newborn infants.
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