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Research Abstracts Online
January - December 2011

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University of Minnesota Twin Cities
Medical School
Department of Pediatrics

PI: Raghevendra Rao

Prediction of Hypoglycemic Brain Injury Using Serum Metabolomics

Hypoglycemia (blood glucose less than 40 mg/dl) is common in 50-75% of preterm infants and those born to mothers with diabetes or hypertension in pregnancy. Hypoglycemia is also common with insulin therapy for type 1diabetes in children. Severe and recurrent hypoglycemia can cause permanent brain injury. The current management of hypoglycemia in children is not ideal. The diagnosis and treatment is based on blood glucose levels, which do not accurately reflect the dynamic metabolic changes in the brain during hypoglycemia. This is because, in addition to glucose, the developing brain can use non-glucose substrates (lactate, ketone bodies, and amino acids) for its energy needs. The participation of these alternate substrates is not taken into account in the management decisions.

A better knowledge of the metabolic changes in the brain would help optimize hypoglycemia management. Such assessments are possible using magnetic resonance (NMR) spectroscopy. However, in vivo NMR spectroscopy studies are not always practical in clinical settings. They require sedation and anesthesia, and are difficult to perform in critically ill children. Moreover, the method is not available in resource-poor locations. Metabolomic analysis of readily accessible body fluids, such as serum or urine, is a promising new investigation that could overcome these difficulties.

NMR spectroscopy is commonly used for metabolomic analysis of the serum or urine. The advantages of this method are high sensitivity and reproducibility, relatively short measuring time, and need for small sample volumes, which is important for studies in children. The purpose of this research is to establish the feasibility and reliability of serum and urine metabolomics for detecting neurological effects of hypoglycemia in newborn infants and animal models.

Group Member

Kathleen Czerniak, Staff