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胰岛素和膳食肌醇对急性链脲佐菌素糖尿病患者外周运动神经传导速度受损的影响。

Effects of insulin and dietary myoinositol on impaired peripheral motor nerve conduction velocity in acute streptozotocin diabetes.

作者信息

Greene D A, De Jesus P V, Winegrad A I

出版信息

J Clin Invest. 1975 Jun;55(6):1326-36. doi: 10.1172/JCI108052.

Abstract

The factors influencing the development of impaired sciatic motor nerve conduction velocity (MNCV) in acute experimental diabetes were examined. Decreased MNCV developed by the 14th day after streptozotocin administration but only in rats which became hyperglycemic. Insulin treatment, begun on day 3, failed to prevent imparied MNCV in diabetic rats in which improved or normal weight gain and a decreased degree of hyperglycemia was induced. However, insulin treatment prevented the development of impaired MNCV in a group of diabetic rats in which the tail vein plasma glucose concentration was never found to exceed 160 mg/dl during days 6 through 14, andin which the mean plus or minus SEM of the average plasma glucose concentration for each animal during the same period was 75 plus or minus 18 mg/dl. In normal rats fed diets containing 0.011% or 0.069% free myoinositol (a presumably normal range), sciatic nerve free myoinositol concentrations were 90- and 60-fold higher than those in plasma. On these diets the development of impaired MNCV in the diabetics was associated with a decrease in nerve free myoinositol as compared with nerves from normals fed the same diet, despite similar plasma levels in the normals and diabetics. Plasma and nerve free myoinositol increased with increasing dietary myoinositol content in both normals and diabetics, and nerve myoinositol content could be acutely increased by an i.p. myoinositol load. By supplementing the diets with 1.0% myoinositol, the difference in nerve myoinositol in normal and diabetic rats on day 14 was abolished; on this diet the development of impaired MNCV in the diabetics was moderated or totally prevented, despite persistent hyperglycemia and elevated nerve sorbitol and fructose concentrations. Insulin treatment that prevented impaired MNCV prevented a decrease in nerve myoinositol in diabetics. These studies suggest that insulin deficiency, and possibly hyperglycemia, are primary factors in the development of imparied MNCV in acute experimental diabetes. However, the development of impaired MNCV appears to be related in some manner to a derangement in the regulation of nerve free myoinositol content, which appears to be subject to modification by increases in plasma myoinositol concentration over a critical range.

摘要

研究了影响急性实验性糖尿病中坐骨神经运动神经传导速度(MNCV)受损发展的因素。链脲佐菌素给药后第14天出现MNCV降低,但仅在血糖升高的大鼠中出现。第3天开始的胰岛素治疗未能预防糖尿病大鼠MNCV受损,这些大鼠体重增加改善或正常,血糖升高程度降低。然而,胰岛素治疗预防了一组糖尿病大鼠MNCV受损的发展,在第6天至14天期间,该组大鼠尾静脉血浆葡萄糖浓度从未超过160mg/dl,并且在此期间每只动物平均血浆葡萄糖浓度的平均值±标准误为75±18mg/dl。在喂食含0.011%或0.069%游离肌醇(推测为正常范围)饮食的正常大鼠中,坐骨神经游离肌醇浓度比血浆中的高90倍和60倍。在这些饮食中,与喂食相同饮食的正常大鼠的神经相比,糖尿病大鼠中MNCV受损的发展与神经游离肌醇的减少有关,尽管正常大鼠和糖尿病大鼠的血浆水平相似。正常大鼠和糖尿病大鼠的血浆和神经游离肌醇均随饮食中肌醇含量的增加而增加,腹腔注射肌醇负荷可使神经肌醇含量急性增加。通过在饮食中补充1.0%的肌醇,第14天正常大鼠和糖尿病大鼠神经肌醇的差异消失;在这种饮食中,尽管持续高血糖以及神经山梨醇和果糖浓度升高,但糖尿病大鼠中MNCV受损的发展得到缓解或完全预防。预防MNCV受损的胰岛素治疗可防止糖尿病大鼠神经肌醇减少。这些研究表明,胰岛素缺乏以及可能的高血糖是急性实验性糖尿病中MNCV受损发展的主要因素。然而,MNCV受损的发展似乎在某种程度上与神经游离肌醇含量调节紊乱有关,在临界范围内血浆肌醇浓度的增加似乎会对其产生影响。

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Peripheral nerve conduction in diabetic neuropathy.糖尿病性神经病变中的周围神经传导
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