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Titolo:
THE EFFECT OF ORAL TERBUTALINE ON MATERNAL GLUCOSE-METABOLISM AND ENERGY-EXPENDITURE IN PREGNANCY
Autore:
SMIGAJ D; ROMANDRAGO NM; AMINI SB; CARITIS SN; KALHAN SC; CATALANO PM;
Indirizzi:
CASE WESTERN RESERVE UNIV,METROHLTH MED CTR,DEPT REPROD BIOL,2500 METROHLTH DR CLEVELAND OH 44109 CASE WESTERN RESERVE UNIV,METROHLTH MED CTR,DEPT REPROD BIOL CLEVELAND OH 44109 CASE WESTERN RESERVE UNIV,DEPT PEDIAT CLEVELAND OH 44109 UNIV PITTSBURGH,MAGEE WOMENS HOSP,DEPT OBSTET & GYNECOL PITTSBURGH PA15213
Titolo Testata:
American journal of obstetrics and gynecology
fascicolo: 5, volume: 178, anno: 1998,
pagine: 1041 - 1047
SICI:
0002-9378(1998)178:5<1041:TEOOTO>2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
EPINEPHRINE; SUBSTRATE; HUMANS; RESISTANCE; SECRETION; RITODRINE; DISPOSAL; THERAPY; INVIVO; WOMEN;
Keywords:
TERBUTALINE; PREGNANCY; INSULIN RESISTANCE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
25
Recensione:
Indirizzi per estratti:
Citazione:
D. Smigaj et al., "THE EFFECT OF ORAL TERBUTALINE ON MATERNAL GLUCOSE-METABOLISM AND ENERGY-EXPENDITURE IN PREGNANCY", American journal of obstetrics and gynecology, 178(5), 1998, pp. 1041-1047

Abstract

OBJECTIVE: Terbutaline, a selective beta(2)-agonist, is a frequently used tocolytic known to affect maternal metabolism. The purpose of this study was to evaluate the effect of oral terbutaline on maternal glucose metabolism and energy expenditure. STUDY DESIGN: Six healthy pregnant women with normal glucose tolerance were evaluated between 30 and34 weeks' gestation. Oral terbutaline was administered to determine the effects on hepatic glucose production with [6-6(2)H(2)] glucose tracer, insulin sensitivity (hyperinsulinemic-euglycemic clamp), and energy expenditure (indirect calorimetry). Terbutaline, insulin, and glucagon levels were also obtained. Subjects were randomly assigned to either oral terbutaline 5 mg every 6 hours for 24 hours or no medication. Repeat studies were conducted 1 week apart, each subject serving as her own control. RESULTS: In the basal state terbutaline was associated with epsilon, trend toward increased basal glucose levels (81.6 +/- 6.6 vs 93.7 +/- 12.0 mg/dl, p = 0.06) but no significant increase in hepatic glucose production (3.2 +/- 0.3 vs 3.6 +/- 0.4 mg/kg fat-free mass/min, p = 0.23). However, there was a significant increase in basal insulin concentration (17.6 +/- 9.2 vs 25.6 +/- 10.4 mu U/ml, p = 0.02). There was a 28% decrease in insulin sensitivity as measured by the glucose infusion rate during the euglycemic clamp plus residual hepaticglucose turnover (5.78 +/- 1.91 vs 4.16 +/- 1.49 mg/kg fat-free mass/min, p = 0.005). Glucagon concentration was significantly decreased both in the basal state (163 +/- 26 vs 144 +/- 27 pg/ml, p = 0.0007) andduring the clamp (144 +/- 27 vs 133 +/- 27 pg/ml, p = 0.003). Basal oxygen consumption increased 9% (270 +/- 49 vs 294 +/- 50 mi oxygen/min, p = 0.007) and caloric expenditure 14% (1.32 +/- 0.23 vs 1.50 +/- 0.31 kcal/min, p = 0.025) or 260 kcal/day with terbutaline. CONCLUSION: Decreased peripheral insulin sensitivity and to a lesser degree increased endogenous glucose production, may represent the pathophysiology of abnormal glucose tolerance observed in many women treated with oral terbutaline. Common side effects such as temors and tachycardia experienced by many women on a regimen of terbutaline are consistent with our finding of a significant in basal energy expenditure.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 20/09/20 alle ore 19:04:20