Abstract 1649 Poster Session I, Saturday, 5/1 (poster 115)

Apnea occurs commonly in preterm infants. Theophylline is used as prophylaxis and treatment. Apart from improving ventilatory function it may also have metabolic effects, including such on glucose metabolism and lipolysis. No data are available on the effect of theophylline on glucose production and lipolysis in preterm infants at start of medication.

Ten preterm infants with gestational ages of ≤32 weeks, postnatal ages of 10-84 h and birth weights above 900 g were recruited. All infants were clinically stable.

Hepatic glucose production and lipolysis were measured after constant rate infusion of [6,6-2H2]-glucose and [2-13C]-glycerol tracers by use of gas chromatography/mass spectrometry. Plasma glucose levels increased following theophylline administration (mean ± SD, 4.0 ± 1.9 mmol · L-1 before and 4.7 ± 2.1 mmol · L-1 after start of therapy), whereas the rate of glucose production decreased (6.0 ± 2.5 mg · kg-1 · min-1 and 4.3 ± 1.9 mg · kg-1 · min-1 respectively). The plasma glycerol concentration did not show any change after theophylline administration (154 ± 257 µmol · L-1 before and 217 ± 258 µmol · L-1 after) and the same was true for the rate of glycerol production (5.9 ± 2.6 µmol · kg-1 · min-1 before and 6.7 ± 3.0 µmol · kg-1 · min-1 after). The fraction of glycerol converted into glucose did not change significantly but the percentage of glucose derived from glycerol increased following theophylline administration.

The results are in line with the lack of adverse metabolic effects at start of theophylline treatment in the preterm infant.