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Clinical Chemistry 40: 526-530, 1994;
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Clinical Chemistry, Vol 40, 526-530, Copyright © 1994 by American Association for Clinical Chemistry

Early detection of metabolic abnormalities in preterm infants impaired by disorders of blood glucose concentrations

H Lyall, A Burchell, PW Howie, S Ogston and R Hume
Department of Obstetrics and Gynaecology, Ninewells Hospital and Medical School, University of Dundee, Scotland, UK.

We recently reported (Acta Paediatr Scand 1992;8: 580-4) three preterm infants with severe respiratory distress syndrome and abnormal glucose profiles for the first 5 days of life who subsequently died in infancy; only at autopsy were they shown to have abnormal glucose-6-phosphatase activity. We have therefore studied retrospectively in a matched cohort of 109 infants the blood glucose profiles correlated with the severity of respiratory distress syndrome (expressed as the fraction of inspired oxygen, FiO2): group A, mild, FiO2 < 0.25; group B, moderate, FiO2 0.26- 0.50; group C, severe, FiO2 > 0.51. All groups had a similar frequency of low blood glucose values (15% < or = 2.2 mmol/L; 29% < or = 2.6 mmol/L), but high blood glucose values and greater variability in glucose values were more common in groups B and C despite lower caloric intakes (A, 4.3%; B, 9.3%; C, 9.6% > or = 7 mmol/L). We conclude that the early blood glucose patterns in those three previously described preterm infants with abnormal hepatic glucose-6-phosphatase activity at autopsy cannot be viewed as abnormal when considered against a matched cohort of infants. Preterm infants at risk of genetic or developmental delays in blood glucose homeostasis should be reassessed after recovery from their acute illnesses.


The following articles in journals at HighWire Press have cited this article:


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L. Jackson, F. L. R. Williams, A. Burchell, M. W. H. Coughtrie, and R. Hume
Plasma Catecholamines and the Counterregulatory Responses to Hypoglycemia in Infants: A Critical Role for Epinephrine and Cortisol
J. Clin. Endocrinol. Metab., December 1, 2004; 89(12): 6251 - 6256.
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 Arch. Dis. Child. Fetal Neonatal Ed.Home page
L Jackson, A Burchell, A McGeechan, and R Hume
An inadequate glycaemic response to glucagon is linked to insulin resistance in preterm infants?
Arch. Dis. Child. Fetal Neonatal Ed., January 1, 2003; 88(1): F62 - 66.
[Abstract] [Full Text] [PDF]

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 Arch. Dis. Child. Fetal Neonatal Ed.Home page
A Burchell, A McGeechan, and R Hume
Therapeutic insulin and hepatic glucose-6-phosphatase activity in preterm infants
Arch. Dis. Child. Fetal Neonatal Ed., May 1, 2000; 82(3): 228F - 232.
[Abstract] [Full Text]


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