Abstract
Background: During late gestation the fetus accumulates fat and glycogen for the immediate postnatal period. Newborn infants of diabetic mothers as well as other infants with hyperinsulinemia have particularly large energy depots and are at risk for hypoglycemia. Large for gestational age (LGA) infants, without known predisposing factors, also have increased energy stores. The relative proportion of this group of infants is increasing. Only limited data is available on the metabolic adaptation of these infants.
Aim: To study lipolysis and glucose production in infants born LGA of non diabetic mothers.
Methods: Eight term LGA infants, were studied at a postnatal age of 19±8-h. Gestational age was 40±1.5 w and birthweight 4.87±0.44 kg. Rates of lipolysis and glucose production (GPR) were analysed by gas chromatography-mass spectrometry following constant rate infusion of [2–13C]-glycerol and [6,6–2H2]-glucose.
Results: Plasma glucose and glycerol averaged 3.8 ± 0.6 mmol. L-1 and 418 ± 190 ±mol. L-1, respectively. Glycerol production, reflecting lipolysis, was 13.2±2.9 ìmol. kg-1. min-1 and GPR averaged 5.5±0.9 mg. kg-1. min-1 (30.6±5.ìmol. kg-1. min-1). The fraction of glycerol converted into to glucose was 54±22 % contributing to 11±6 % of the total glucose production. Lipolysis and GPR correlated to birth weight. Plasma concentrations of insulin and glucagon averaged 11±3 mU. L-1 and 39±4 pmol. L-1, respectively.
Conclusion: The results show that term LGA infants have a markedly increased lipolysis during the first day of life as compared to term infants born appropriate for gestational age (AGA). The correlation to birth weight indicates that the degree of lipolysis is dependent on the amount of stored fat in the LGA infants. GPR was similar to that observed in AGA infants. There was no pronounced hyperinsulinemia, which contradicts the occurrence of insulin resistance in this particular group of infants.
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ahlsson, F., Diderholm, B., Ewald, U. et al. 3 Increased Lipolysis in Large for Gestational Age Infants. Pediatr Res 56, 464 (2004). https://doi.org/10.1203/00006450-200409000-00026
Issue date:
DOI: https://doi.org/10.1203/00006450-200409000-00026
