Influence of gestational age on serum incretin levels in preterm infants

2016 ◽  
Vol 7 (6) ◽  
pp. 685-688 ◽  
Author(s):  
H. Shoji ◽  
A. Watanabe ◽  
N. Ikeda ◽  
M. Mori ◽  
T. Kitamura ◽  
...  
Keyword(s):  
Insulin Secretion ◽  
Preterm Infants ◽  
Enteral Feeding ◽  
Gestational Age ◽  
Serum Insulin ◽  
Insulin Level ◽  
Postnatal Period ◽  
Early Group ◽  
Insulin Levels ◽  
Late Group

Glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) are the incretin hormones secreted from the intestine in response to enteral feeding to stimulate insulin secretion. We investigated the relationship serum GIP and GLP-1 levels with gestational age, and insulin secretion in preterm infants. Serum GIP and GLP-1 levels were measured at birth and at 1, 2 and 4 weeks after birth in 30 infants, including 12 born before 30th week of gestation (early group) and 18 born after 30th week of gestation (late group). Blood glucose and serum insulin levels were measured, and the quantitative insulin sensitivity check index (QUICKI) was also calculated. The levels of GLP-1 at 2 and 4 weeks were significantly higher in the early group than those in the late group. The levels of GIP were not significantly different between two groups. At 4 weeks, serum insulin level was significantly higher and QUICKI was significantly lower in the early group. Furthermore, GLP-1 levels were significantly correlated with QUICKI and the serum insulin levels in all infants at 4 weeks. In preterm infants, enteral feeding to premature intestine may be associated with GLP-1 secretion. GLP-1 is also related to stimulated insulin secretion in early postnatal period.

scholarly journals Oropharyngeal Administration of Colostrum for Preventing Necrotizing Enterocolitis and Late-onset Sepsis in Preterm Infants with Gestational Age ≤ 32 Weeks: A Single-center Randomized Controlled Trial

2021 ◽  
Author(s):  
xia ouyang ◽  
changyi yang ◽  
wenlong xiu ◽  
yanhua hu ◽  
susu mei ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Necrotizing Enterocolitis ◽  
Enteral Feeding ◽  
Gestational Age ◽  
Late Onset ◽  
Controlled Trial ◽  
Control Group ◽  
Clinical Trial Registry ◽  
Late Onset Sepsis ◽  
Full Enteral Feeding

Abstract BackgroundOropharyngeal administration of colostrum (OAC) may provide immunoprotective and anti-inflammatory effects that potentially reduce the incidence of necrotizing enterocolitis (NEC) and late-onset sepsis (LOS) and improve short-term outcomes.ObjectiveTo evaluate the role of OAC in the early prevention of NEC and LOS in preterm infants with gestational age (GA) ≤ 32 weeks.MethodsA randomized, placebo-controlled trial was conducted in a 40-bed tertiary neonatal intensive care unit (NICU) in China. Preterm infants with GA ≤ 32 weeks were divided randomly into an OAC group, which received 0.4 ml maternal colostrum smearing via the oropharyngeal route every 3 hours for 10 days beginning within the first 48 hours after birth, and a control group, which received normal saline instead. Data from the two groups were collected and compared.ResultsA total of 127 patients in the OAC group and 125 patients in the control group were finally enrolled. The incidence of NEC (Bell stage 2 or 3) and LOS was lower in the OAC group [2.4% vs. 10.4%, χ2 = 6.845, ༰=0.009; 4.7% vs. 13.6%, χ2 = 5.983, ༰=0.014]. In addition, the incidence of intraventricular hemorrhage (IVH) (stage 3 or 4) was lower [1.6% vs. 7.2%,χ2 = 4.775, ༰=0.029], and the time of achieving full enteral feeding was shorter [ 22.0 days vs. 25.0 days༌Z = 6༌424.500༌P = 0.009)] in the OAC group. No cases of adverse reactions were observed in either group.ConclusionsOAC is a safe and simple NICU procedure that yields a potential advantage in decreasing the incidence of NEC, LOS, and severe IVH and shortening the time to achieve full enteral feeding in preterm infants with GA ≤ 32 weeks.Trial registrationChinese Clinical Trial Registry, ChiCTR1900023697, Registered 8 June 2019, Retrospectively registered, http://www.chictr.org.cn/edit.aspx? pid = 39398

Gender-specific regulation of pancreatic islet blood flow, insulin levels and glycaemia in spontaneously diabetic Goto–Kakizaki rats

2008 ◽  
Vol 115 (1) ◽  
pp. 35-42 ◽  
Author(s):  
Zhen Huang ◽  
Leif Jansson ◽  
Åke Sjöholm
Keyword(s):  
Blood Flow ◽  
Insulin Secretion ◽  
Blood Glucose ◽  
Enzyme Inhibitor ◽  
Serum Insulin ◽  
Metabolic Effects ◽  
Male Rats ◽  
Insulin Levels ◽  
Islet Blood Flow ◽  
Specific Regulation

Patients with diabetes are often treated with a statin for hyperlipidaemia and an ACE (angiotensin-converting enzyme) inhibitor or angiotensin receptor antagonist for hypertension or albuminuria. These drugs may also exert beneficial metabolic effects, causing improved glucose tolerance in patients. Gender-related differences have also been observed in the clinical responsiveness to these drugs, but the mechanism behind this is unclear. In the present study, we have investigated whether these drugs and the fatty acid palmitate influence the pancreatic microcirculation, thereby having an impact on insulin secretion and glycaemia in vivo, in spontaneously diabetic male and female Goto–Kakizaki rats. In male rats, pancreatic IBF (islet blood flow) and total PBF (pancreatic blood flow) were increased significantly by pravastatin, captopril and irbesartan. Serum insulin levels were increased by pravastatin and captopril. Palmitate suppressed pancreatic IBF and increased blood glucose. In female animals, pancreatic IBF was stimulated by captopril, candesartan and irbesartan. Total PBF was increased by captopril, candesartan and irbesartan, and by pravastatin. Palmitate suppressed pancreatic IBF and serum insulin secretion. In conclusion, the present study lends support to the view that a local pancreatic RAS (renin–angiotensin system) and pravastatin may be selectively influencing the pancreatic microcirculation and therefore affecting insulin secretion and glycaemia. NEFAs (non-esterified fatty acids) impaired pancreatic IBF, suppressed insulin secretion and increased blood glucose. Substantial gender-related differences in the vascular and metabolic responses to these drugs prevail in this animal model of diabetes.

scholarly journals Inhibition of Ghrelin Activity by Receptor Antagonist [d-Lys-3] GHRP-6 Attenuates Alcohol-Induced Hepatic Steatosis by Regulating Hepatic Lipid Metabolism

Biomolecules ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. 517 ◽  
Author(s):  
Karuna Rasineni ◽  
Jacy L. Kubik ◽  
Carol A. Casey ◽  
Kusum K. Kharbanda
Keyword(s):  
Insulin Secretion ◽  
Fatty Acid ◽  
Lipid Metabolism ◽  
Receptor Antagonist ◽  
Hepatic Steatosis ◽  
De Novo ◽  
Serum Insulin ◽  
Acid Uptake ◽  
Hepatic Lipid ◽  
Insulin Levels

Alcoholic steatosis, characterized by an accumulation of triglycerides in hepatocytes, is one of the earliest pathological changes in the progression of alcoholic liver disease. In our previous study, we showed that alcohol-induced increase in serum ghrelin levels impair insulin secretion from pancreatic β-cells. The consequent reduction in the circulating insulin levels promote adipose-derived fatty acid mobilization to ultimately contribute to hepatic steatosis. In this study, we determined whether inhibition of ghrelin activity in chronic alcohol-fed rats could improve hepatic lipid homeostasis at the pancreas–adipose–liver axis. Adult Wistar rats were fed Lieber-DeCarli control or an ethanol liquid diet for 7 weeks. At 6 weeks, a subset of rats in each group were injected with either saline or ghrelin receptor antagonist, [d-Lys-3] GHRP-6 (DLys; 9 mg/kg body weight) for 5 days and all rats were sacrificed 2 days later. DLys treatment of ethanol rats improved pancreatic insulin secretion, normalized serum insulin levels, and the adipose lipid metabolism, as evidenced by the decreased serum free fatty acids (FFA). DLys treatment of ethanol rats also significantly decreased the circulating FFA uptake, de novo hepatic fatty acid synthesis ultimately attenuating alcoholic steatosis. To summarize, inhibition of ghrelin activity reduced alcoholic steatosis by improving insulin secretion, normalizing serum insulin levels, inhibiting adipose lipolysis, and preventing fatty acid uptake and synthesis in the liver. Our studies provided new insights on the important role of ghrelin in modulating the pancreas–adipose–liver, and promoting adipocyte lipolysis and hepatic steatosis. The findings offer a therapeutic approach of not only preventing alcoholic liver injury but also treating it.

scholarly journals Timing of initial surfactant treatment in very low birth weight newborns

2010 ◽  
Vol 8 (3) ◽  
pp. 320-324
Author(s):  
Celso Moura Rebello ◽  
Luciene Ferreira do Amaral Nacif ◽  
Alice D´Agostini Deutsch ◽  
Ângela Tavares Paes
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Bronchopulmonary Dysplasia ◽  
Gestational Age ◽  
Very Low Birth Weight ◽  
Early Group ◽  
Air Leak ◽  
Intermediate Group ◽  
Air Leak Syndrome ◽  
Late Group

ABSTRACT Objective: To correlate the timing of treatment using exogenous surfactant with the main variables related to respiratory distress syndrome or prematurity. Methods: A historic cohort study between January 1, 2004 and June 30, 2007, including very low birth weight newborns (birth weight <1,500 g) admitted to the hospital and who required surfactant therapy. Newborns were divided into three study groups: early (treatment during the first two hours); intermediate (treatment between two and six hours) and late (treatment after six hours). Variables analyzed were: air leak syndrome, mortality, bronchopulmonary dysplasia, intracranial hemorrhage, patent ductus arteriosus, retinopathy of prematurity, duration of oxygen therapy, duration of mechanical ventilation, length of hospital stay and number of surfactant doses. Results: A total of 63 newborns were included (Early Group, n = 21; Intermediate Group, n = 26 and Late Group, n = 16), there was a statistical significance between birth weight and gestational age. Multivariate logistic regression analysis was used to compensate the effects of gestational age, birth weight and other possible interferences over the variables. This analysis revealed a greater incidence of air leak syndrome among newborns of the Early Group compared to the Intermediate Group (OR = 6.98; 95%CI = 1.24-39.37; p = 0.028), with no difference compared to the Late Group (OR = 3.72; 95% CI = 0.28-49.76; p = 0.321). There were no differences regarding the other variables analyzed. Conclusions: In this retrospective, non-randomized study, surfactant administration during the first two hours of life enhanced the risk of air leak syndrome, compared to the treatment between two and six hours after birth, with no reduction of early or late neonatal mortality or bronchopulmonary dysplasia, compared to later treatment after birth.

scholarly journals Prediabetes and serum insulin levels

2018 ◽  
Vol 5 (5) ◽  
pp. 1684 ◽  
Author(s):  
Alwaleed Altemani ◽  
Ali Alamri ◽  
Mahir Ahmed ◽  
Mosaed Al Garbo ◽  
Tariq Alharbi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Serum Insulin ◽  
Insulin Level ◽  
Accurate Identification ◽  
Diagnostic Dilemma ◽  
Insulin Levels ◽  
Promising Tool ◽  
Prevention Of Diabetes ◽  
Microvascular And Macrovascular Complications ◽  
Fasting Insulin Level

Prediabetes remains a diagnostic dilemma. It refers to impaired glycaemic values without reaching the threshold for diagnosing diabetes mellitus. Prediabetes is an important risk factor for the development of diabetes mellitus, and it constitutes the stage during which microvascular and macrovascular complications are initiated. Early and accurate identification of this stage is the gold standard for prevention of diabetes and its consequences. Despite the multiplicity of diagnostic tests proposed for identification of this condition, a reliable test remains elusive. This article aims at reviewing the different available tests for diagnosis of prediabetes states with a focus on serum insulin levels. Insulin plays a major role in the pathophysiology and development of prediabetes. Different mechanisms of insulin resistance and insulin secretion are established in different subtypes of prediabetes. Therefore, fasting insulin level seems to be a reliable and promising tool for diagnosis and management of prediabetes.  

Insulin secretory dynamics during development of rat pancreas

1980 ◽  
Vol 239 (1) ◽  
pp. E57-E63 ◽  
Author(s):  
W. B. Rhoten
Keyword(s):  
Insulin Secretion ◽  
High Glucose ◽  
Glucose Concentration ◽  
Insulin Level ◽  
Rapid Onset ◽  
High Concentration ◽  
Rat Pancreas ◽  
Insulin Levels ◽  
High Level

The dynamics of insulin secretion during development of the fetal rat pancreas were investigated. The time of onset of glucose-induced insulin secretion was of special interest. Pancreases from 15- to 22-day-old fetal rats were perifused in vitro with low (0.5 or 0.9 mg/ml) or high (5 mg/ml) concentrations of glucose in the presence or absence of arginine and leucine. Levels of insulin in the perifusate were determined by radioimmunoassay. At day 17, a significant increase in perfusate insulin level was observed in response to arginine and leucine (each at 5 mM), This response was independent of a high concentration of glucose. In addition, perifusate insulin levels were augmented when the concentration of amino acids were kept constant and the glucose concentration was changed from a high level to a low level. On day 20, a monophasic, rapid-onset short-duration rise in insulin release with a high glucose concentration was observed. This response was enhanced by acetylcholine (2.7 x 10(-9) M). At days 21 and 22, insulin levels rose rapidly in the presence of high glucose and remained elevated. The results show that there is considerable precision in the timing of the onset and maturation of the glucose-induced insulin secretory response prenatally and reaffirm that insulin secretion by the fetal beta-cell varies with the stimulus applied.

scholarly journals A case of low serum insulin levels in a patient with insulinoma

2016 ◽  
Vol 2016 ◽  
Author(s):  
Chun-Han Lo ◽  
Ding-Ping Sun
Keyword(s):  
Ct Scan ◽  
Serum Insulin ◽  
Laboratory Data ◽  
Insulin Level ◽  
Laparoscopic Distal Pancreatectomy ◽  
List Type ◽  
Previous Night ◽  
C Peptide ◽  
Insulin Levels ◽  
Glucose Levels

Summary Insulinomas are the most common cause of hypoglycemia resulting from endogenous hyperinsulinism. Traditionally, inappropriately elevated levels of insulin in the face of hypoglycemia are the key to diagnosis. However, contradictory levels of insulin and C-peptide do not necessarily exclude the diagnosis. A 50-year-old female was brought to our emergency department because of conscious disturbance on the previous night. She had no history of diabetes mellitus, and was not using any medications or alcohol. Laboratory data showed low sugar, a significantly low insulin level, and elevated C-peptide. After admission, she had multiple episodes of spontaneous hypoglycemia after overnight fasts without discomfort. It was considered that a neuroendocrine tumor was the source of her hypoglycemia. CT scan of the abdomen revealed a 1.1cm hypervascular nodule in the pancreatic tail. Elective laparoscopic distal pancreatectomy was incorporated into her treatment course. A 1.2×1.0cm homogenous well-encapsulated tumor was resected. We monitored her glucose levels in the outpatient clinic every month for a period of six months. She did not have another episode of spontaneous hypoglycemia. Learning points Insulinoma causes endogenous hypoglycemia – it cannot be ruled out in patients presenting with hypoglycemia and low insulin levels; history and imaging studies should be done for further assessment A 24-h fast test has the same clinical significance as that of 72-h fast test C-peptide is a useful biochemical marker in addition to serum insulin, which can be used to diagnose insulinomas CT scan is used to measure the tumor size and localize the tumor. However, definitive diagnosis is only achieved through histopathologic evaluation of diseased tissue

scholarly journals SAT-103 Extrauterine Growth Restriction (EUGR) in Preterm Infants: Incidence, Risk Factors, Nutrition, Auxological and Neurological Outcome.A Retrospective Study from 2010 to 2016

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Marta Del Pistoia ◽  
Maria Giulia Tozzi ◽  
Alessandra Carmignani ◽  
Massimiliano Ciantelli ◽  
Rosa Teresa Scaramuzzo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Enteral Feeding ◽  
Gestational Age ◽  
Minimum Weight ◽  
Gradual Improvement ◽  
Increased Risk

Abstract EUGR is still a serious problem in very low birth weight preterm infants. The gradual improvement in neonatal intensive care has allowed the survival of newborns with increasing low weight and gestational age, with a higher incidence of major nutritional problems and diseases (Goldenberg 2008). EUGR was defined as growth parameters ≤ 10° centile at discharge, compared to the expected intrauterine growth for post-menstrual age. Recently EUGR was defined, in a dynamic way, as the reduction in anthropometric parameters z-score between birth and discharge &gt;1SD (Griffin 2016). Aims of our study were to evaluate: the incidence of EUGR, the nutritional intake, the main risk factors, the auxological and neurological outcome. We enrolled 346 newborns admitted to our NICU from 2010 to 2016 with gestational age (GA) at birth &lt; 30 weeks and/or birth weight &lt;1500 gr. Infants with malformations or syndromes were excluded. The incidence of EUGR was 73.1% for weight, 66.3% for length and 39.3% for head circumference. We observed a decrease in SD mainly during the first 14 days of life. From two weeks to discharge, no significant catch-up growth was observed. Risk factors for EUGR were: male gender, reduced GA (p=0.000), low birth weight (p=0.000), lower minimum weight achieved (p=0.000), more time to recover birth weight (p=0.000), lower growth rate per day (p=0.001), longer period of total parenteral nutrition (p=0.008), later onset of minimal enteral feeding (p=0.006), later achievement of the full enteral feeding (p=0.000), cesarean section (p=0.006), incomplete corticosteroid prophylaxis (p=0.025), postnatal steroids use (p=0.000), mechanical ventilation (p=0.000), pulmonary bronchodysplasia (p= 0.000), leukomalacia (p=0.06), patent ductus arteriosus (p=0.000), retinopathy of prematurity (p= 0.008), late onset sepsis (p= 0.09). In 197 patients post-discharge clinical follow up at 1, 3 and 24 months of correct age (CA) was performed. Around 88% of all our sample showed normal neurological development. 12% at 1 and 3 months had abnormal general movements (both writhing and fidgety movements) or absent (p = 0.001). At 24 months CA patients with abnormal/absent fidgety movements had neurological disabilities and 83% were EUGR. At 24 months, 17% had weight &lt;10th centile and all were EUGR. 25% showed an overgrowth (weight &gt;75th centile) with a probably increased risk of metabolic disease later in life. The incidence of EUGR increased over the years due to the augmentation in preterm births with lower GA. The first 14 days of life were a critical period and nutrition is known to be mandatory to promote newborns’ growth (Asbury 2019). The EUGR condition negatively affected the neurological (Chien 2018) and auxological (Takayanagi 2018, Wood 2018) outcome of preterm infants and the early recognition of this condition is extremely important in order to implement a careful and prolonged follow-up.

scholarly journals Waist circumference and insulin levels in obese children

2017 ◽  
Vol 57 (4) ◽  
pp. 194
Author(s):  
Vina Paramitha Cempaka ◽  
I Gusti Lanang Sidiartha
Keyword(s):  
Metabolic Syndrome ◽  
Waist Circumference ◽  
Serum Insulin ◽  
Fasting Blood Glucose ◽  
Insulin Level ◽  
Obese Children ◽  
Blood Draw ◽  
Simple Method ◽  
Positive Correlation ◽  
Insulin Levels

Background Childhood obesity is one of the most serious public health challenges of the 21st century. Its prevalence has increased at an alarming rate. Overweight and obese children are prone to obesity in adulthood and to developing non-communicable diseases (NCDs) like diabetes and cardiovascular diseases at a younger age. Increased waist circumference has been shown to contribute to the risk of metabolic syndrome in obese adults.Objective To assess for a correlation between waist circumference and insulin level in obese children.Methods In this cross-sectional study, obese children aged 6-10 years were included by consecutive sampling. We excluded children with infectious disease, malignancy, dyslipidemia, type 2 diabetes mellitus, or those who had not fasted before the blood draw. Subjects underwent waist circumference and fasting blood glucose measurements. Serum insulin levels were examined by enzyme-labeled chemiluminescent immunometric assay,after subjects had fasted for 10-14 hours. Data were analyzed by correlation analysis.Results Subjects had a mean waist circumference of 80.2 cm (SD 7.2) and mean insulin level of 10.70 (SD 7.5). µIU/mL Pearson’s correlation test revealed a significant, moderately positive correlation between waist circumference and elevated insulin level (r=0.45; P=0.006).Conclusion Waist circumference and insulin level have a significant, moderate, positive correlation in obese children. As such, waist circumference may be a simple method for early detection of hyperinsulinemia, as a risk factor for metabolic syndrome.

scholarly journals Regulation of islet function and gene expression by prolactin during pregnancy

2019 ◽  
Author(s):  
Vipul Shrivastava ◽  
Megan Lee ◽  
Marle Pretorius ◽  
Guneet Makkar ◽  
Carol Huang
Keyword(s):  
Gene Expression ◽  
Insulin Secretion ◽  
Serum Insulin ◽  
Prolactin Receptor ◽  
Cell Mass ◽  
Insulin Level ◽  
Β Cells ◽  
Β Cell

AbstractPancreatic islets adapt to insulin resistance of pregnancy by up regulating β-cell proliferation and increase insulin secretion. Previously, we found that prolactin receptor (Prlr) signaling is important for this process, as heterozygous prolactin receptor-null (Prlr+/−) mice are glucose intolerant, had a lower number of β cells and lower serum insulin levels than wild type mice during pregnancy. However, since Prlr expression is ubiquitous, to determine its β-cell specific effects, we generated a transgenic mouse with a floxed Prlr allele under the control of an inducible promoter, allowing conditional deletion of Prlr from β cells in adult mice. In this study, we found that β-cell-specific Prlr reduction resulted in elevated blood glucose during pregnancy. Similar to our previous finding in mouse with global Prlr reduction, β-cell-specific Prlr loss led to a lower β-cell mass and a lower in vivo insulin level during pregnancy. However, these islets do not have an intrinsic insulin secretion defect when tested in vitro. Interestingly, when we compared the islet gene expression profile, using islets isolated from mice with global versus β-cell-specific Prlr reduction, we found some important differences in genes that regulate apoptosis and insulin secretion. This suggests that Prlr has both cell-autonomous and non-cell-autonomous effect on β cells, beyond its regulation of pro-proliferative genes.

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