미숙아 혈당 조절 장애
Glucose Homeostasis Disorders in Premature Infants
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An abnormal plasma glucose concentration is one of the most commonly encountered metabolic problems in the intensive care of premature infants. Compared with term infants, glycogen reserves are lower in the preterm neonatal liver. Despite this, preterm infants are at a greater risk of hyperglycemia than term infants are, which is owing to comparable production rate of endogenous glucose and impaired ability to reduce glucose production rate in response to hyperglycemia. Debate continues about the normal plasma glucose concentrations and the guideline for glucose control in premature infants. Some randomized controlled trials in very low birth weight infants demonstrated little clinical benefit of tight glycemic control with early insulin therapy and higher calorie intake in terms of mortality, morbidities and growth parameters. Compared with term infants, preterm infants have limited endocrine and metabolic adaptation to hypoglycemia. In any case, hypoglycemia in premature infants should not be considered a physiologic condition. The operational criteria for intervention of hypoglycemia should be different from that in term infants. Continuous non-invasive glucose monitoring is a promising tool considering the principle of minimal handling of extremely premature infants. However, the clinical implication of abnormal glucose concentrations, previously undetected on intermittent measurements, is unclear.
Abstract
An abnormal plasma glucose concentration is one of the most commonly encountered metabolic problems in the intensive care of premature infants. Compared with term infants, glycogen reserves are lower in the preterm neonatal liver. Despite this, preterm infants are at a greater risk of hyperglycemia than term infants are, which is owing to comparable production rate of endogenous glucose and impaired ability to reduce glucose production rate in response to hyperglycemia. Debate continues about the normal plasma glucose concentrations and the guideline for glucose control in premature infants. Some randomized controlled trials in very low birth weight infants demonstrated little clinical benefit of tight glycemic control with early insulin therapy and higher calorie intake in terms of mortality, morbidities and growth parameters. Compared with term infants, preterm infants have limited endocrine and metabolic adaptation to hypoglycemia. In any case, hypoglycemia in premature infants should not be considered a physiologic condition. The operational criteria for intervention of hypoglycemia should be different from that in term infants. Continuous non-invasive glucose monitoring is a promising tool considering the principle of minimal handling of extremely premature infants. However, the clinical implication of abnormal glucose concentrations, previously undetected on intermittent measurements, is unclear.
참고문헌 (60)
- Hauguel S, "Glucose uptake, utilization, and transfer by the human placenta as functions of maternal glucose concentration", Pediatr Res, 20, pp.269~273 (1986)
- Ashmead GG, "Maternalfetal substrate relationships in the third trimester in human pregnancy", Gynecol Obstet Invest, 35, pp.18~22 (1993)
- Hay WW, Jr., "Simultaneous measurements of umbilical uptake, fetal utilization rate, and fetal turnover rate of glucose", Am J Physiol, 240, pp.E662~668 (1981)
- Kalhan SC, "Glucose production in pregnant women at term gestation", J Clin Invest, 63, pp.388~394 (1979)
- Marconi AM, "An evaluation of fetal glucogenesis in intrauterine growth-retarded pregnancies", Metabolism, 42, pp.860~864 (1993)
- Girard J, "Gluconeogenesis in late fetal and early neonatal life", Biol Neonate, 50, pp.237~258 (1986)
- Mena P, "Insulin homeostasis in the extremely low birth weight infant", Semin Perinatol, 6, pp.436~446 (2001)
- Shelley HJ, "Neonatal hypoglycaemia", Br Med Bull, 22, pp.34~39 (1966)
- Heck LJ, "Serum glucose levels in term neonates during the first 48 hours of life", J Pediatr, 110, pp.119~122 (1987)
- Mitanchez D, "Glucose regulation in preterm newborn infants", Horm Res, 68, pp.265~271 (2007)
- Denne SC, "Glucose carbon recycling and oxidation in human newborns", Am J Physiol, 251, pp.E71~77 (1986)
- Kalhan SC, "Measurement of glucose turnover in the human newborn with glucose-1-13C", J Clin Endocrinol Metab, 43, pp.704~707 (1976)
- Reinauer H, "Determination of glucose turnover and glucose oxidation rates in man with stable isotope tracers", J Clin Chem Clin Biochem, 28, pp.505~511 (1990)
- Sunehag A, "Glucose production rate in extremely immature neonates (<28 weeks)studied by use of deuterated glucose", Pediatr Res, 33, pp.97~100 (1993)
- Thureen PJ, "Early aggressive nutrition in the neonate", Neoreviews, 20, pp.e45~55 (1999)
- Settergren G, "Cerebral blood flow and exchange of oxygen, glucose, ketone bodies, lactate, pyruvate and amino acids in infants", Acta Paediatr Scand, 65, pp.343~353 (1976)
- Kalhan SC, "Estimation of gluconeogenesis in newborn infants", Am J Physiol Endocrinol Metab, 281, pp.E991~997 (2001)
- Sunehag A, "Glycerol carbon contributes to hepatic glucose production during the first eight hours in healthy term infants", Acta Paediatr, 85, pp.1339~1343 (1996)
- Sunehag AL, "Gluconeogenesis in very low birth weight infants receiving total parenteral nutrition", Diabetes, 48, pp.791~800 (1999)
- van Kempen AA, "Stimulation of gluconeogenesis by intravenous lipids in preterm infants: response depends on fatty acid profile", Am J Physiol Endocrinol Metab, 290, pp.E723~730 (2006)
- Cowett RM, "Persistent glucose production during glucose infusion in the neonate", J Clin Invest, 71, pp.467~475 (1983)
- Farrag HM, "Persistent glucose production and greater peripheral sensitivity to insulin in the neonate vs. the adult", Am J Physiol, 272, pp.E86~93 (1997)
- Mitanchez-Mokhatari D, "Both Relative Insulin Resistance and Defective Islet β-Cell", Processing of. Pediatrics, 113, pp.537~541 (2004)
- Blanco CL, "Peripheral insulin resistance and impaired insulin signaling contribute to abnormal glucose metabolism in preterm baboons", Endocrinology, 156, pp.813~823 (2015)
- Grasso S, "Inhibition of glucagon secretion in the human newborn by glucose infusion", Diabetes, 32, pp.489~492 (1983)
- Binder ND, "Insulin infusion with parenteral nutrition in extremely low birth weight infants with hyperglycemia", J Pediatr, 114, pp.273~280 (1989)
- Kalhan SC, "Fanaroff and Martins neonatal-perinatal medicine : diseases of the fetus and infant", pp.1497~1620 (2010), Mosby
- Jain V, "Avery's diseases of the newborn", pp.1320~1329 (2011), Saunders
- Hey E, "Hyperglycaemia and the very preterm baby", Semin Fetal Neonatal Med, 10, pp.377~387 (2005)
- Kairamkonda VR, "Controversies in the management of hyperglycemia in the ELBW infant", Indian Pediatr, 45, pp.29~38 (2008)
- Gilmore RM, "The role of hyperglycemia in acute ischemic stroke", Neurocrit Care, 5, pp.153~158 (2006)
- Barbagallo M, "Type 2 diabetes mellitus and Alzheimer’s disease", World J Diabetes, 5, pp.889~893 (2014)
- Sullivan PM, "Retinal blood flow during hyperglycemia. A laser Doppler velocimetry study", Invest Ophthalmo Vis Sci, 31, pp.2041~2045 (1990)
- Antonetti DA, "Diabetic retinopathy", N Engl J Med, 366, pp.1227~1239 (2012)
- Au SC, "Association between hyperglycemia and retinopathy of prematurity: a systemic review and meta-analysis", Sci Rep, 5, pp.9091~ (2015)
- Coulthard MG, "Renal processing of glucose in well and sick neonates", Arch Dis Child Fetal Neonatal Ed, 81, pp.F92~98 (1999)
- Wilkins BH, "Renal function in sick very low birthweight infants:4. Glucose excretion", Arch Dis Child, 67, pp.1162~1165 (1992)
- Van den Berghe G, "Outcome benefit of intensive insulin therapy in the critically ill: Insulin dose versus glycemic control", Crit Care Med, 31, pp.359~366 (2003)
- Finfer S, "Hypoglycemia and risk of death in critically ill patients", N Eng J Med, 367, pp.1108~1118 (2012)
- Finfer S, "Intensive versus Conventional Glucose Control in Critically Ill patients", N Engl J Med, 360, pp.1283~1297 (2009)
- Macrae D, "A randomized trial of hyperglycemic control in pediatric intensive care", N Engl J Med, 370, pp.107~118 (2014)
- Agus MS, "Tight glycemic control versus standard care after pediatric cardiac surgery", N Engl J Med, 367, pp.1208~1219 (2012)
- Collins JW, "A controlled trial of insulin infusion and parenteral nutrition in extremely low birth weight infants with glucose intolerance", J Pediatr, 118, pp.921~927 (1991)
- Meetze W, "Hyperglycemia in extremely- low-birth-weight infants", Biol Neonate, 74, pp.214~221 (1998)
- Beardsall K, "Early insulin therapy in very-low-birth-weight infants", N Engl J Med, 359, pp.1873~1884 (2008)
- Alsweiler JM, "Tight glycemic control with insulin in hyperglycemic preterm babies: a randomized controlled trial", Pediatrics, 129, pp.639~647 (2012)
- Srinivasan G, "Plasma glucose values in normal neonates: a new look", J Pediatr, 109, pp.114~117 (1986)
- Adamkin DH, "Postnatal glucose homeostasis in late-preterm and term infants", Pediatrics, 127, pp.575~579 (2011)
- Koh TH, "Neural dysfunction during hypoglycaemia", Arch Dis Child, 63, pp.1353~1358 (1988)
- Burns CM, "Patterns of cerebral injury and neurodevelopmental outcomes after symptomatic neonatal hypoglycemia", Pediatrics, 122, pp.65~74 (2008)
- Boluyt N, "Neurodevelopment after neonatal hypoglycemia: a systematic review and design of an optimal future study", Pediatrics, 117, pp.2231~2243 (2006)
- Lucas A, "Adverse neurodevelopmental outcome of moderate neonatal hypoglycaemia", BMJ, 297, pp.1304~1308 (1988)
- Anwar M, "Autoradiographic determination of regional cerebral blood flow during hypoglycemia in newborn dogs", Pediatr Res, 24, pp.41~45 (1988)
- Pryds O, "Increased cerebral blood flow and plasma epinephrine in hypoglycemic, preterm neonates", Pediatrics, 85, pp.172~176 (1990)
- de Rooy L, "Nutritional factors that affect the postnatal metabolic adaptation of full-term small- and large-forgestational-age infants", Pediatrics, 109, pp.E42~ (2002)
- Hawdon JM, "Patterns of metabolic adaptation for preterm and term infants in the first neonatal week", Arch Dis Child, 67, pp.357~365 (1992)
- Harris DL, "Lactate, rather than ketones, may provide alternative cerebral fuel in hypoglycaemic newborns", Arch Dis Child Fetal Neonatal Ed, 100, pp.F161~164 (2015)
- Collins JE, "Hyperinsulinaemic hypoglycaemia in small for dates babies", Arch Dis Child, 65, pp.1118~1120 (1990)
- Harris DL, "Continuous glucose monitoring in newborn babies at risk of hypoglycemia", J Pediatr, 157, pp.198~202 (2010)
- Pertierra-Cortada A, "Instability of glucose values in very preterm babies at term postmenstrual age", J Pediatric, 165, pp.1146~1153 (2014)
