The Journal of pediatrics · 2025
Association of Catecholamines with Blood Glucose and Severity of Illness in Infants Born Preterm.
СтатьяНазвание и аннотация: Перевод в очереди
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Hoermann Henrike, Roeper Marcia, van Faassen Martijn, Hagenbeck Carsten, Herebian Diran, Muller Kobold Anneke C, Dukart Juergen, Kema Ido P, Mayatepek Ertan, Meissner Thomas, Kummer Sebastian
Аннотация
OBJECTIVE: To assess whether urinary catecholamine/metanephrine concentrations correlate with illness severity and blood glucose (BG) levels during the first weeks of life among infants born preterm.
STUDY DESIGN: This was a prospective cohort study of 33 neonates born at <32 + 0 weeks or with a birth weight <1500 g. Urine was collected 2-3x/week up to 10 weeks of age. Catecholamines/metanephrines were analyzed by an isotope dilution liquid chromatography in combination with tandem mass spectrometry. Severity of illness was estimated using the Neonatal Therapeutic Intervention Scoring System and the number of apneas/bradycardias. BG levels were measured as clinically indicated.
RESULTS: Six hundred fifteen urine samples and 3491 BG levels were analyzed. Median age at lowest BG was 686 (IQR 27, 2420) hours for infants <1000 g, 20 (IQR 1, 165) hours for infants between 1000-1499 g and 4 (IQR 1, 104) hours for infants >1500 g. Three neonates were diagnosed with transient hyperinsulinism. Urinary norepinephrine and metanephrine correlated positively with the Neonatal Therapeutic Intervention Scoring System (F(1, 58.73) = 33.24, P < .001; F(1, 310.01) = 19.78, P < .001). Norepinephrine, normetanephrine, and metanephrine correlated positively with the number of apneas/bradycardias during the last 6 hours before urine collection (F(1, 442.69) = 22.12, P < .001; F(1, 598) = 7.40, P = .007; F(1, 591.50) = 29.05, P < .001). Norepinephrine and normetanephrine concentrations correlated positively with BG levels (F(1, 314.6) = 8.58, P = .004; F(1, 312.5) = 10.40, P = .001).
CONCLUSION: Urinary catecholamines in infants born preterm correlate with severity of illness and BG levels. Whether postnatal catecholamines directly influence beta-cell physiology in infants born preterm remains to be elucidated and should be addressed in future studies. A better understanding of the biologic mechanism might help improve glucose management in this vulnerable population.
TRIAL REGISTRATION: German Clinical Trials Register: DRKS00026230; https://drks.de/search/de/trial/DRKS00026230/details.
STUDY DESIGN: This was a prospective cohort study of 33 neonates born at <32 + 0 weeks or with a birth weight <1500 g. Urine was collected 2-3x/week up to 10 weeks of age. Catecholamines/metanephrines were analyzed by an isotope dilution liquid chromatography in combination with tandem mass spectrometry. Severity of illness was estimated using the Neonatal Therapeutic Intervention Scoring System and the number of apneas/bradycardias. BG levels were measured as clinically indicated.
RESULTS: Six hundred fifteen urine samples and 3491 BG levels were analyzed. Median age at lowest BG was 686 (IQR 27, 2420) hours for infants <1000 g, 20 (IQR 1, 165) hours for infants between 1000-1499 g and 4 (IQR 1, 104) hours for infants >1500 g. Three neonates were diagnosed with transient hyperinsulinism. Urinary norepinephrine and metanephrine correlated positively with the Neonatal Therapeutic Intervention Scoring System (F(1, 58.73) = 33.24, P < .001; F(1, 310.01) = 19.78, P < .001). Norepinephrine, normetanephrine, and metanephrine correlated positively with the number of apneas/bradycardias during the last 6 hours before urine collection (F(1, 442.69) = 22.12, P < .001; F(1, 598) = 7.40, P = .007; F(1, 591.50) = 29.05, P < .001). Norepinephrine and normetanephrine concentrations correlated positively with BG levels (F(1, 314.6) = 8.58, P = .004; F(1, 312.5) = 10.40, P = .001).
CONCLUSION: Urinary catecholamines in infants born preterm correlate with severity of illness and BG levels. Whether postnatal catecholamines directly influence beta-cell physiology in infants born preterm remains to be elucidated and should be addressed in future studies. A better understanding of the biologic mechanism might help improve glucose management in this vulnerable population.
TRIAL REGISTRATION: German Clinical Trials Register: DRKS00026230; https://drks.de/search/de/trial/DRKS00026230/details.