Energy expenditure, lipolysis, and glucose production in preterm infants treated with theophylline

Carla R. Fjeld, F. Sessions Cole, Dennis M. Bier

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Theophylline is administered to preterm in­fants with pulmonary disease to improve pulmonary func­tion and reduce apneic episodes. Because it potentially mediates both a-and β-receptor-effector mechanisms, we tested the hypothesis that it increases lipolysis, gluconeo-genesis from glycerol, and energy expenditure in 16 pre­term infants, eight of whom were treated therapeutically with theophylline for apnea of prematurity (T) and eight of whom were controls (C). Mean ± SD postnatal ages were 4.8 ± 1.9 wk (T) and 2.4 ± 0.9 wk (C) (p < 0.01). Corrected gestational ages were 35 ± 1.6 wk (T) and 34 ± 0.5 wk (C) (p = NS). Body weights were 1.69 ± 0.13 kg (T) and 1.70 ± 0.23 kg (C) (p = NS). All infants were clinically stable, breathing room air, fed enterally, and receiving no diuretics, steroids, or antibiotics. Lipolysis, hepatic glucose production, and gluconeogenesis from glyc­erol were measured using [2-13C]glycerol and [6,6-3H2] glucose tracers. Body water and energy expenditure were measured by the2H218O method. Body water volumes were 68.5 ± 3.4% body weight (T) and 70.2 ± 3.4% (C) (p = NS), suggesting fat was 10-13% of body weight in both groups. Mean daily energy expenditure was 65 ± 22 kcal/ kg body weight/d (T) versus 59 ± 5 kcal/kg body weight/d (C) (j) = NS). Between 4 and 6 h after a feeding, glucose production rates were 40.5 ±4.3 μmol/kg/min (T) and 37.6 ± 4.8 jumol/kg/min (C) (p = NS). Plasma glycerol appear­ance rate, an index of lipolysis, was nearly equivalent in both groups, averaging 9.6 ± 2 μmol/kg/min (T) and 9.3 ± 2.4 μmol/kg/min (C). Glycerol accounted for 10 ± 2% (T) and 10 ± 4% (C) of new glucose carbon (p = NS). We conclude that energy expenditure, body composition, lipol­ysis, glucose production, and gluconeogenesis from glycerol are not altered in preterm infants with apnea of prematurity treated therapeutically with theophylline, and therefore speculate that theophylline treatment is not a major deter­rent of weight gain in premature infants with lung disease. The data suggest further that lipid mobilization may al­ready be stimulated maximally 4 to 6 h after the last feeding in preterm infants studied 1 mo after birth.

Original languageEnglish
Pages (from-to)693-698
Number of pages6
JournalPediatric research
Issue number6
StatePublished - Dec 1992


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