Association of Fetal Catecholamines With Neonatal Hypoglycemia

医学 低血糖 内分泌学 新生儿低血糖 胎儿 妊娠期 联想(心理学) 怀孕 胰岛素 儿科 产科 妊娠期糖尿病 认识论 哲学 生物 遗传学
作者
Henrike Hoermann,Martijn van Faassen,Marcia Roeper,Carsten Hagenbeck,Diran Herebian,Anneke C. Muller Kobold,Juergen Dukart,Ido P. Kema,Ertan Mayatepek,Thomas Meißner,Sebastian Kummer
出处
期刊:JAMA Pediatrics [American Medical Association]
卷期号:178 (6): 577-577 被引量:3
标识
DOI:10.1001/jamapediatrics.2024.0304
摘要

Importance Perinatal stress and fetal growth restriction increase the risk of neonatal hypoglycemia. The underlying pathomechanism is poorly understood. In a sheep model, elevated catecholamine concentrations were found to suppress intrauterine insulin secretion, followed by hyperresponsive insulin secretion once the adrenergic stimulus subsided. Objective To determine whether neonates with risk factors for hypoglycemia have higher catecholamine concentrations in umbilical cord blood (UCB) and/or amniotic fluid (AF) and whether catecholamines are correlated with postnatal glycemia. Design, Setting, and Participants In a prospective cohort study of 328 neonates at a tertiary perinatal center from September 2020 through May 2022 in which AF and UCB were collected immediately during and after delivery, catecholamines and metanephrines were analyzed using liquid chromatography with tandem mass spectrometry. Participants received postnatal blood glucose (BG) screenings. Exposure Risk factor for neonatal hypoglycemia. Main Outcomes and Measures Comparison of catecholamine and metanephrine concentrations between at-risk neonates and control participants, and correlation of concentrations of catecholamines and metanephrines with the number and severity of postnatal hypoglycemic episodes. Results In this study of 328 neonates (234 in the risk group: median [IQR] gestational age, 270 [261-277] days; and 94 in the control group: median [IQR] gestational age, 273 [270-278] days), growth-restricted neonates showed increased UCB median (IQR) concentrations of norepinephrine (21.10 [9.15-42.33] vs 10.88 [5.78-18.03] nmol/L; P < .001), metanephrine (0.37 [0.13-1.36] vs 0.12 [0.08-0.28] nmol/L; P < .001), and 3-methoxytyramine (0.149 [0.098-0.208] vs 0.091 [0.063-0.149] nmol/L; P = .001). Neonates with perinatal stress had increased UCB median (IQR) concentrations of norepinephrine (22.55 [8.99-131.66] vs 10.88 [5.78-18.03] nmol/L; P = .001), normetanephrine (1.75 [1.16-4.93] vs 1.25 [0.86-2.56] nmol/L; P = .004), and 3-methoxytyramine (0.120 [0.085-0.228] vs 0.091 [0.063-0.149] nmol/L; P = .008) ( P < .0083 was considered statistically significant). Concentrations of UCB norepinephrine, metanephrine, and 3-methoxytyramine were negatively correlated with AF C-peptide concentration ( r s = −0.212, P = .005; r s = −0.182, P = .016; and r s = −0.183, P = .016, respectively [ P < .017 was considered statistically significant]). Concentrations of UCB norepinephrine, metanephrine, and 3-methoxytyramine were positively correlated with the number of hypoglycemic episodes (BG concentration of 30-45 mg/dL) ( r s = 0.146, P = .01; r s = 0.151, P = .009; and r s = 0.180, P = .002, respectively). Concentrations of UCB metanephrine and 3-methoxytyramine were negatively correlated with the lowest measured BG concentration ( r s = −0.149, P = .01; and r s = −0.153, P = .008, respectively). Conclusions and Relevance Neonates at risk for hypoglycemia displayed increased catecholamine and metanephrine concentrations that were correlated with postnatal hypoglycemic episodes and lower BG levels; these results are consistent with findings in a sheep model that fetal catecholamines are associated with neonatal β-cell physiology and that perinatal stress or growth restriction is associated with subsequent neonatal hyperinsulinemic hypoglycemia. Improving the pathomechanistic understanding of neonatal hypoglycemia may help to guide management of newborns at risk for hypoglycemia.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
庾楼月宛如昨完成签到 ,获得积分10
刚刚
群体医学的master完成签到,获得积分10
刚刚
serpant完成签到,获得积分10
1秒前
Yulei_Qian完成签到,获得积分10
1秒前
seven完成签到,获得积分10
2秒前
2秒前
笨蛋小章完成签到 ,获得积分10
2秒前
紧张的败发布了新的文献求助30
2秒前
白芷当归发布了新的文献求助10
2秒前
wanci应助乘风破浪采纳,获得10
3秒前
可爱的函函应助周洋采纳,获得10
3秒前
啊啊完成签到,获得积分10
3秒前
zhchong5发布了新的文献求助10
3秒前
玲子发布了新的文献求助10
4秒前
栗子的小母牛完成签到,获得积分10
4秒前
zhaxiao发布了新的文献求助10
4秒前
4秒前
CJ发布了新的文献求助10
5秒前
5秒前
领导范儿应助Cc采纳,获得10
5秒前
吓死你都有完成签到,获得积分10
5秒前
CF发布了新的文献求助10
6秒前
7秒前
liyanly2025发布了新的文献求助10
7秒前
7秒前
8秒前
8秒前
9秒前
9秒前
9秒前
锦诗完成签到,获得积分10
10秒前
舒心的访冬完成签到 ,获得积分10
10秒前
10秒前
11秒前
xxxx完成签到,获得积分10
11秒前
小白发布了新的文献求助10
11秒前
11秒前
量子星尘发布了新的文献求助10
13秒前
小马甲应助逃跑快人一步采纳,获得10
13秒前
hky发布了新的文献求助10
13秒前
高分求助中
Picture Books with Same-sex Parented Families: Unintentional Censorship 700
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
Effective Learning and Mental Wellbeing 300
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3974712
求助须知:如何正确求助?哪些是违规求助? 3519159
关于积分的说明 11197254
捐赠科研通 3255257
什么是DOI,文献DOI怎么找? 1797724
邀请新用户注册赠送积分活动 877130
科研通“疑难数据库(出版商)”最低求助积分说明 806132