OBJECTIVES: To explore the relationships between postmenstrual age (PMA), insulin, C-peptide, glucagon and blood glucose concentrations (BGCs) in preterm and term neonates. To compare glucagon-like peptide-1 (GLP-1) concentrations in fed versus never-fed neonates. DESIGN: Observational. SETTING: Dunedin Hospital Neonatal Intensive Care Unit, New Zealand. PATIENTS: Term or preterm euglycaemic neonates (102) receiving routine blood tests (343 samples). INTERVENTIONS: None: plasma was obtained from surplus samples from routine clinical care. MAIN OUTCOME MEASURES: Insulin, C-peptide, GLP-1 and glucagon concentrations were measured in temporal association with BGC. RESULTS: Insulin and C-peptide concentrations were elevated in very preterm infants (PMA≤32 weeks) and decreased to term; this relationship persisted when BGCs were accounted for. Generalised linear mixed models showed that insulin:C-peptide ratio and insulin:BGC ratio decreased significantly with increasing PMA (p<0.001). GLP-1 increased following initial oral feeds regardless of PMA (p<0.001). CONCLUSION: Preterm neonates exhibit insulin resistance in the absence of hyperglycaemia. Enteral feeds result in an increase in GLP-1. These factors are likely to contribute to the increased risk of hyperglycaemia in premature neonates (PMA<32 weeks). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
OBJECTIVES: To explore the relationships between postmenstrual age (PMA), insulin, C-peptide, glucagon and blood glucose concentrations (BGCs) in preterm and term neonates. To compare glucagon-like peptide-1 (GLP-1) concentrations in fed versus never-fed neonates. DESIGN: Observational. SETTING: Dunedin Hospital Neonatal Intensive Care Unit, New Zealand. PATIENTS: Term or preterm euglycaemic neonates (102) receiving routine blood tests (343 samples). INTERVENTIONS: None: plasma was obtained from surplus samples from routine clinical care. MAIN OUTCOME MEASURES: Insulin, C-peptide, GLP-1 and glucagon concentrations were measured in temporal association with BGC. RESULTS:Insulin and C-peptide concentrations were elevated in very preterm infants (PMA≤32 weeks) and decreased to term; this relationship persisted when BGCs were accounted for. Generalised linear mixed models showed that insulin:C-peptide ratio and insulin:BGC ratio decreased significantly with increasing PMA (p<0.001). GLP-1 increased following initial oral feeds regardless of PMA (p<0.001). CONCLUSION: Preterm neonates exhibit insulin resistance in the absence of hyperglycaemia. Enteral feeds result in an increase in GLP-1. These factors are likely to contribute to the increased risk of hyperglycaemia in premature neonates (PMA<32 weeks). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Authors: Jane K Naberhuis; Agus Suryawan; Hanh V Nguyen; Adriana Hernandez-Garcia; Stephanie M Cruz; Patricio E Lau; Oluyinka O Olutoye; Barbara Stoll; Douglas G Burrin; Marta L Fiorotto; Teresa A Davis Journal: Am J Physiol Endocrinol Metab Date: 2019-09-10 Impact factor: 4.310