EFFECT OF INTRAVENOUS HYDROCORTISONE ADMINISTRATION ON GLUCOSE HOMEOSTASIS IN SMALL FOR GESTATIONAL AGE INFANTS

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Abstract
The effects of i.v. hydrocortisone (H) (10 mg/kg) on glucose homeostasis were evaluated at 25-85 h of age in 14 infants who were small for gestational age (SGA) in comparison to 17 control SGA infants. Three h after H administration, higher levels of plasma glucose than in controls were detected (mean .+-. S.E.M. [standard error of the mean]): 4.78 .+-. 0.2 vs. 2.88 .+-. 0.2 mM (P < 0.01), while lower levels were found for blood pyruvate (38 .+-. 7 vs. 89 .+-. 12 .mu.M-P < 0.01), plasma insulin (6.4 .+-. 0.5 vs. 12 .+-. 0.8 .mu.IU/ml-P < 0.05) and plasma glucagon (62.25 .+-. 6.6 vs. 81.6 .+-. 6.6 pM-P < 0.05). Three h after H administration, i.v. injection of L-alanine (150 mg/kg) produced a significant rise over baseline of plasma glucose concentration from 4.78 .+-. 0.2 to 5.94 .+-. 0.2 mM at 50 min (P < 0.05), whereas no significant change was observed in controls. There was no significant change in plasma glucagon and insulin concentrations after L-alanine injection in either group. These results show that in SGA infants primed with H, the rise of plasma glucose concentration after L-alanine administration was observed with low plasma insulin levels and without stimulation of glucagon secretion. Apparently, H induced a reduced peripheral utilization of glucose by lowering the plasma levels of insulin and production of glucose from alanine through gluconeogenesis.