SummaryThe available information on the qualitative and quantitative aspects of maternofetal transfer of these nutrients, as well as data We have the in which One uterine artery is concerning possible alterations in their tissue distribution during ligated to study maternofetal transport and tissue uptake of gluof limited transfer are scanty. cose and amino acids in the intrauterine growth-retarded rat. OnIn order to gain more insight into maternofetal transport and the 18th day of gestation, the artery supplying one uterine horn tissue uptake of glucose and amino acids in IUGR, we have Was ligated. Two days later the rats received I3Hl2-deox~ducose employed the model devised by Wigglesworth (3 I), in which the and 114Cla-aminoisobutyric acid iv. One hour later the growth-artery to one uterine horn is ligated. Our goal in these initial retarded and control fetuses were delivered by Cesarean section studies was primarily to test the assumption that in this model and were obtained' The Uterine blood flow restriction limits the rate of glucose and amino tarded fetuses had an average weight reduction of 27%, signifi-acid transport to the placenta and fetus. To the best of our cantly increased placental to fetal weight ratio and brain to body knowledge, this assumption has not been examined in any animal ratio, and a significantly reduced liver to body ratio. Total radio-system where maternal flow restriction has been induced. In activity derived from tritiated deoxyglucose in whole fetal tissues, exploring placental transport and tissue uptake, further metabom placenta, liver, and brain were significantly decreased in the lism of the in question should ideally be excluded. intrauterine growth-retarded (IUGR) fetuses; this was also true For this reason radioactive analogs of glucose and amino acids per gram of tissue except for liver' Liver to plasma, brrfin .to known to undergo little or no further intracellular alteration were plasma, and whole fetal tissue to plasma 3Hwere slgnlfi-used. The results of some of our initial studies are here. cantly increased in the IUGR group. The radioactivity derived from ['4Cla-aminoisobutyric acid was significantly reduced in whole fetal tissues, placenta, liver, and brain in the IUGR fetuses MATERIALS AND METHODSwhether expressed per whole organ or per gram of tissue. Significant differences in liver to plasma, brain to plasma, and whole ANIMALS AND SURGICAL PROCEDURE tissue to plasma 14C ratios were not observed.The experiment involved six pregnant Sprague-Dawley rats Speculation with accurately timed gestations (within 12 hr). They were caged individually and given free access to Purina laboratory pellets and The large reduction in maternofetal transfer of deoxyglucose tap water until the time of surgery. Experimental intrauterine and a-aminoisobutryric acid when uterine blood flow is reduced growth retardation was induced by slight modification (18) of a raises the possibility that one of the major causes of retarded previously described procedure (31). On the 18th day of ges...
(Arch Dis Child 1995; 73: 338-341)
Celiac disease was diagnosed by jejunal biopsy and response to gluten elimination in 11 of 23 children with short stature referred after negative endocrine evaluation. The mean age of the group was 11 years, with a range of 5-16. All had been followed for a mean of 2.5 years at a large pediatric endocrine clinic for the evaluation of growth retardation. Bone age retardation of more than 25 percent of the chronologic age was found in all children. Microcytic anemia and past history of gastrointestinal problems were typical of the celiac group but were not documented in the nonceliac patients. Stool fat excretion was a specific but insensitive test, while the 1-hour blood xylose test was of no value in differentiating between the two groups. Close cooperation between pediatric endocrinology and gastroenterology clinics may be fruitful in the identification of celiac patients, especially in a group of older children with short stature, bone age retardation, and microcytic anemia.
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