Abstract
BACKGROUND: At discharge from neonatal units, many preterm infants are vulnerable to preprandial hypoglycemia due to insufficient liver glucose production. In most preterm infants, hepatic glucose-6-phosphatase activity (the terminal step of liver glucose production) remains abnormally low postnatally.
OBJECTIVE:
To determine what perinatal factors are associated with changes in hepatic glucose-6-phosphatase enzyme activity.
STUDY DESIGN:
The maximum velocity (Vmax) of the hepatic microsomal glucose-6-phosphatase enzyme, as the dependant variable, was correlated by stepwise multiple regression analysis with clinical data from a consecutive series of 45 preterm infants from a level 3 neonatal unit.
RESULTS:
Significant factors (p ≤ 0.0005) were the presence of pathogenic bacteria isolated from maternal high vaginal swabs (p ≤ 0.0000), hyperkalemia regimen, duration of prenatal exposure to ritodrine, and delivery mode. Further analysis revealed that the highest correlation was with positive early postdelivery infant bacterial cultures.
CONCLUSION: Perinatal events and clinical interventions modulate key enzyme systems necessary for human adaptation to extrauterine life.
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The work carried out was supported by grants from the Scottish Home and Health Department (to A. B. and R. H.), British Diabetic Association (to A. B.), Wellcome Trust (to R. H.), Tenovus (Scotland) (to R. H., A. B.), Research Trust for Metabolic Diseases in Children (to A. B.), Paediatric Metabolic Research Trust (to R. H.), and Northwood Charitable Trust (to A. B.). A. B. was a Lister Institute Research Fellow. Dr Simon Ogston, University of Dundee gave advice on statistical analysis.
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Hume, R., McGeechan, A. & Burchell, A. Perinatal Factors Influencing Hepatic Glucose-6-Phosphatase Enzyme Activity. J Perinatol 20, 301–306 (2000). https://doi.org/10.1038/sj.jp.7200379
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DOI: https://doi.org/10.1038/sj.jp.7200379
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