Alternative Cerebral Fuels in the First Five Days in Healthy Term Infants: The Glucose in Well Babies (GLOW) Study.

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dc.contributor.author Harris, Deborah L
dc.contributor.author Weston, Philip J
dc.contributor.author Harding, Jane E
dc.coverage.spatial United States
dc.date.accessioned 2021-12-08T22:43:14Z
dc.date.available 2021-12-08T22:43:14Z
dc.date.issued 2021-4
dc.identifier.issn 0022-3476
dc.identifier.uri https://hdl.handle.net/2292/57704
dc.description.abstract <h4>Objectives</h4>To determine plasma lactate and beta-hydroxybutyrate (BHB) concentrations of healthy infants in the first 5 days and their relationships with glucose concentrations.<h4>Study design</h4>Prospective masked observational study in Hamilton, New Zealand. Term, appropriately grown singletons had heel-prick blood samples, 4 in the first 24 hours then twice daily.<h4>Results</h4>In 67 infants, plasma lactate concentrations were higher in the first 12 hours (median, 20; range, 10-55 mg/dL [median, 2.2 mmol/L; range, 1.1-6.2 mmol/L]), decreasing to 12 mg/dL (range, 7-29 mg/dL [median, 1.4 mmol/L; range, 0.8-3.3 mmol/L]) after 48 hours. Plasma BHB concentrations were low in the first 12 hours (median, 0.9 mg/dL; range, 0.5-5.2 mg/dL [median, 0.1 mmol/L; range, 0.05-0.5 mmol/L]), peaked at 48-72 hours (median, 7.3 mg/dL; range, 1.0-25.0 mg/dL [median, 0.7 mmol/L; range, 0.05-2.4 mmol/L]), and decreased by 96 hours (median, 0.9 mg/dL; range, 0.5-16.7 mg/dL [median, 0.1 mmol/L; range, 0.05-1.6 mmol/L]). Compared with infants with plasma glucose concentrations above the median (median, 67 mg/dL [median, 3.7 mmol/L]), those with lower glucose had lower lactate concentrations in the first 12 hours and higher BHB concentrations between 24 and 96 hours. Lower interstitial glucose concentrations were also associated with higher plasma BHB concentrations, but only if the lower glucose lasted greater than 12 hours. Glucose contributed 72%-84% of the estimated potential adenosine triphosphate throughout the 5 days, with lactate contributing 25% on day 1 and BHB 7% on days 2-3.<h4>Conclusions</h4>Lactate on day 1 and BHB on days 2-4 may contribute to cerebral fuels in healthy infants, but are unlikely to provide neuroprotection during early or acute hypoglycemia.<h4>Trial registration</h4>The Australian and New Zealand Clinical Trials Registry: ACTRN12615000986572.
dc.format.medium Print-Electronic
dc.language eng
dc.publisher Elsevier BV
dc.relation.ispartofseries The Journal of pediatrics
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher.
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm
dc.subject Brain
dc.subject Humans
dc.subject Hypoglycemia
dc.subject 3-Hydroxybutyric Acid
dc.subject Lactic Acid
dc.subject Blood Glucose
dc.subject Prospective Studies
dc.subject Single-Blind Method
dc.subject Infant, Newborn
dc.subject Female
dc.subject Male
dc.subject Biomarkers
dc.subject beta-hydroxybutyrate
dc.subject continuous glucose monitoring
dc.subject glucose
dc.subject hypoglycemia
dc.subject infant
dc.subject lactate
dc.subject metabolic adaptation
dc.subject newborn
dc.subject 3-Hydroxybutyric Acid
dc.subject Biomarkers
dc.subject Blood Glucose
dc.subject Brain
dc.subject Female
dc.subject Humans
dc.subject Hypoglycemia
dc.subject Infant, Newborn
dc.subject Lactic Acid
dc.subject Male
dc.subject Prospective Studies
dc.subject Single-Blind Method
dc.subject Science & Technology
dc.subject Life Sciences & Biomedicine
dc.subject Pediatrics
dc.subject 1106 Human Movement and Sports Sciences
dc.subject 1114 Paediatrics and Reproductive Medicine
dc.title Alternative Cerebral Fuels in the First Five Days in Healthy Term Infants: The Glucose in Well Babies (GLOW) Study.
dc.type Journal Article
dc.identifier.doi 10.1016/j.jpeds.2020.12.063
pubs.begin-page 81
pubs.volume 231
dc.date.updated 2021-11-11T17:32:05Z
dc.rights.holder Copyright: The author en
pubs.author-url https://www.ncbi.nlm.nih.gov/pubmed/33373670
pubs.end-page 86.e2
pubs.publication-status Published
dc.rights.accessrights http://purl.org/eprint/accessRights/RetrictedAccess en
pubs.subtype Research Support, Non-U.S. Gov't
pubs.subtype Journal Article
pubs.subtype Observational Study
pubs.elements-id 833933
dc.identifier.eissn 1097-6833
dc.identifier.pii S0022-3476(20)31573-0


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