Consecutive injection of L-alanine and fat emulsion in 4-hour-old small-for-gestational-age (SGA) infants. Effects on plasma concentrations of lipid and carbohydrate metabolites

摘要

In earlier studies we showed that injection of fat emulsion (IntralipidR) corrected the hypoglycemia of 4-hour-old SGA-infants concomitantly with increasing levels of B-OH-butyrate and falling RQ indicating fatty acid oxidation. Other investigators found that hypoglycemic SGA-infants did not raise their blood glucose in response to an intravenous L-alanine load whereas normoglycemic SGA-infants did. In the present study 7 SGA neonates with(N-3) and without(N=4) hypoglycemia (R (0.5 g fat/kg). Plasma concentrations of lipid and carbohydrate metabolites were measured up to 4 hours after fat injection. Blood glucose did not change after L-alanine in the hypoglycemic infants but decreased in the normoglycemic babies, 2 of them becoming hypoglycemic. All 7 infants increased their blood glucose in response to fat administration. Following L-alanine injection there was also a fall in B-OH-butyrate levels simultaneously with decreasing or constantly low blood glucose. This potentially harmful situation was rapidly reversed with fat injection. In conclusion administration of alanine is of no benefit in hypoglycemic SGA-infants and could possibly even be harmful in both hypo- and normoglycemic SGA babies through its antiketogenic effect.