The Role of Free Fatty Acids, Glycerol, Ketone Bodies and Glucose in the Energy Metabolism of the Mother and Fetus during Delivery

Sabata, V; Wolf, Harald; Lausmann, S

doi:10.1159/000240128

Cited by 100 publications

(47 citation statements)

References 6 publications

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“…As has been shown by others, the betahydroxybutyrate concentration in maternal and cord blood followed a pattern which suggested a simple diffusion from the mother to the fetus (41)(42)(43). The fetal capacity to use ketones for oxidation has been evaluated in both human and animal species.…”

Section: Discussionmentioning

confidence: 80%

Glucose Production in Pregnant Women at Term Gestation

Kalhan¹,

D'Angelo²,

Savin³

et al. 1979

J. Clin. Invest.

196

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A B S T R A C T The effects of pregnancy and diabetes on systemic glucose production rates and the sources of glucose for the human fetus in utero were evaluated in five normal, four gestationally diabetic, and one insulin-dependent diabetic subject undergoing elective caesarean section at term gestation. Five normal nonpregnant women were studied for comparison. Systemic glucose production rates were measured with stable tracer [1-13C]glucose according to the primeconstant rate infusion technique. Even though the plasma glucose concentration during normal pregnancy had declined as compared with the nonpregnant subjects (P < 0.0005), the systemic glucose production rate was 16% greater, a rate sufficient to provide the glucose requirement of the fetus at term gestation. The decline in glucose concentration could be the result of an increase in apparent volume of distribution of glucose. Systemic glucose production rates in wellcontrolled, gestationally diabetic subjects were similar to those in normal pregnant subjects (2.07±0.53 vs. 2.42±0.51 mg/kg-min). The sources of glucose for the human fetus at term gestation were evaluated by comparing (a) natural variation in 13C:12C ratio of plasma glucose and (b) enriched '3C:'2C ratio ofplasma glucose during [1-13C]glucose infusion in maternal and fetal blood at delivery in both normal and diabetic subjects. These data showed that the fetal glucose pool was in equilibrium with the maternal glucose pool in both normal and diabetic subjects, indicating that a brief A preliminary report of this work has been published as an abstract: Pediatr. Res. 1977.

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Section: Discussionmentioning

confidence: 80%

Glucose Production in Pregnant Women at Term Gestation

Kalhan¹,

D'Angelo²,

Savin³

et al. 1979

J. Clin. Invest.

196

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“…In species with a more permeable placenta like the rabbit [81][82][83][84], guinea-pig [85,86], rat [87][88][89], rhesus monkey [90] and humans [91][92][93], FFA and ketoacids are readily transferred from the mother to its foetuses. Fatty acids can cross the rabbit placenta in either direction [82].…”

Section: Fatty Acids Ketone Bodies and Glycerolmentioning

confidence: 99%

Materno-foetal exchanges and utilisation of nutrients by the foetus: comparison between species

Père

2003

Reprod. Nutr. Dev.

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-Several general features of nutrient uptake and utilisation by foetuses are similar among mammalian species. Nevertheless, there are also differences linked mainly to differences in placental permeability. Glucose and lactate are the main energetic substrates of the foetus. In normal conditions, the oxidation of carbohydrates accounts for about 75, 60 and 50% of oxygen uptake in the foetal pig, foal and lamb, respectively, and acetate accounts for about 10% in ruminants. Acidic amino acids are synthesised by the foetus, whereas neutral and basic amino acids are transported from the placenta. As shown by the high urea level in foetal blood, amino acids are partly involved in the oxidative metabolism of foetuses; their contribution is higher in ruminants than in humans, horses and pigs. Fatty acids cross the haemochorial placenta of rodents, rabbits and primates, and are incorporated into the foetal lipids, whereas their uptake by ruminant, pig and horse foetuses is very low.materno-foetal exchange / mammal / carbohydrate / fatty acid / amino acid

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“…Although the mechanism of ketone body transfer across the human placenta has not been clearly defined, their concentrations in the fetus have been shown to be closely related to those in maternal plasma (I 7,30-32). Paired umbilical venous-arterial concentrations have been measured in the fetuses of mothers whose total plasma ketone bodies were 0.2-1.4 mM during early and advanced stages of labor (17). It was concluded from these studies that a positive maternofetal gradient exists.…”

Section: Scfmentioning

confidence: 99%

“…In the human myelination is most active during the 3rd trimester and throughout the 1st yr of life (1 1, 12). It has also been demonstrated in both the rat (1 3-1 5) and human (6,8,16) that the uptake of ketone bodies into brain is linearly related to the arterial concentration.The concentrations of the ketone bodies in blood are elevated above typical adult levels both in the fetus during the later half of gestation (8,17) and in the breast-fed term infant (18). These data warrant considering that metabolically stable preterm infants should have a mild ketosis of similar magnitude to that of the fetus at the close of the 3rd trimester.…”

mentioning

confidence: 99%

“…The concentrations of the ketone bodies in blood are elevated above typical adult levels both in the fetus during the later half of gestation (8,17) and in the breast-fed term infant (18). These data warrant considering that metabolically stable preterm infants should have a mild ketosis of similar magnitude to that of the fetus at the close of the 3rd trimester.…”

mentioning

confidence: 99%

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Medium-Chain Triglycerides in Infant Formulas and their Relation to Plasma Ketone Body Concentrations

Edmond

Auestad

et al. 1986

Pediatr Res

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A B S T R A a . A mild ketosis is known to prevail in the mother, fetus, and newborn infant during the 3rd trimester and in the early neonatal period. It has been shown that during an equivalent period in the rat ketone bodies are readily oxidized and serve a s key substrates for lipogenesis in brain. Since medium-chain triglycerides are known to be ketogenic, preterm infants may benefit from dietary medium-chain triglycerides beyond the point of enhanced fat absorption. Our objective was to determine the ketogenic response in preterm infants (gestational age: 33 + 0.8 wk)fed three different isocaloric formulas by measuring the concentrations of 3-hydroxybutyrate and acetoacetate in the plasma of these infants. At the time of entrance to the study the infants were receiving 110 kcallkg124 h. Study I (1 1 infants): the infants were fed sequentially in the order; P M 60140 (PM), Special Care Formula (SCF), and Similac 20 (SIM). In S C F greater than 50% of the fat consists of medium-chain length fatty acids while P M and S I M contain about 25%. The concentration of 3-hydroxybutyrate in plasma was significantly higher when infants were fed S C F than P M and S I M [0.14 2 0.03, 0.06 f 0.01, and 0.05 f: 0.01 mM, respectively ( p < 0.01)j. Study I1 (12 infants); the infants were fed SCF, then SIM, or the reverse. The concentration of acetoacetate in plasma was 0.05 f 0.01 and 0.03 f 0.01 m M when infants were fed S C F and SIM, respectively (0.1 > p > 0.05). The concentrations of 3-hydroxybutyrate in plasma were similar to those measured in study I for the respective formulas. The increased plasma levels of 3-hydroxybutyrate and total ketone bodies when S C F was fed indicate that S C F promotes a mild ketosis in preterm infants similar to that reported in breast-fed term infants. The past decade has witnessed a major change in our concept of ketone bodies from a limited role as alternative oxidative substrates in muscle and brain to a role as key substrates for tissue respiration and lipid synthesis. Recent studies with animal models (1-4) and in human infants (5-9) suggest that the ketone bodies, AcAc and 3HB, may be particularly important in the developing infant. Several investigators have demonstrated that AcAc and 3HB, in addition to serving as general oxidative substrates, are preferentially incorporated into sterols and fatty acids in the neonatal rat brain (1, 2, 10). This occurs during the "brain growth spurt" when cell proliferation and myelination are major developmental events. In the human myelination is most active during the 3rd trimester and throughout the 1st yr of life (1 1, 12). It has also been demonstrated in both the rat (1 3-1 5) and human (6,8,16) that the uptake of ketone bodies into brain is linearly related to the arterial concentration.The concentrations of the ketone bodies in blood are elevated above typical adult levels both in the fetus during the later half of gestation (8,17) and in the breast-fed term infant (18). These data warrant considering that metabolically stable preterm in...

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The Role of Free Fatty Acids, Glycerol, Ketone Bodies and Glucose in the Energy Metabolism of the Mother and Fetus during Delivery

Cited by 100 publications

References 6 publications

Glucose Production in Pregnant Women at Term Gestation

Glucose Production in Pregnant Women at Term Gestation

Materno-foetal exchanges and utilisation of nutrients by the foetus: comparison between species

Medium-Chain Triglycerides in Infant Formulas and their Relation to Plasma Ketone Body Concentrations

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