Karasalihoğlu Serap, Bi Murat, Oner Naci, Celtik Coşkun, Pala Ozer
Department of Pediatrics, University of Trakya, Faculty of Medicine, Edirne, Turkey.
J Trop Pediatr. 2003 Oct;49(5):305-7. doi: 10.1093/tropej/49.5.305.
Potassium deficiency and insulin releasing defect in severe protein-energy malnutrition (PEM) have been reported previously. The aim of this study was to investigate the existence of potassium deficiency and early insulin releasing defect in moderate PEM, which is more common in children. This study was carried out prospectively in the Pediatrics Department at Trakya University. The study group comprised 30 children with moderate PEM who were also classified as stunted, wasted, and stunting-wasting. Thirty healthy children were selected as controls. Although there was no statistical difference between the study and control groups in terms of serum potassium and initial insulin levels, intraerythrocytic potassium and early insulin release in patients were significantly lower than in controls. The stunting-wasting cases had the lowest intraerythrocytic potassium and early insulin response to intravenous glucose administration. This study suggests that it is appropriate to evaluate moderate PEM cases for intraerythrocytic potassium deficiency and early insulin releasing defect. Potassium supplements should be given if necessary.
先前已有报道称,重度蛋白质 - 能量营养不良(PEM)患者存在钾缺乏和胰岛素释放缺陷。本研究的目的是调查中度PEM患者中钾缺乏和早期胰岛素释放缺陷的存在情况,中度PEM在儿童中更为常见。本研究在特拉凯亚大学儿科前瞻性开展。研究组包括30名中度PEM儿童,这些儿童还被分类为发育迟缓、消瘦以及发育迟缓和消瘦并存。选取30名健康儿童作为对照组。尽管研究组和对照组在血清钾和初始胰岛素水平方面无统计学差异,但患者的红细胞内钾和早期胰岛素释放显著低于对照组。发育迟缓和消瘦并存的病例红细胞内钾含量最低,对静脉注射葡萄糖的早期胰岛素反应也最低。本研究表明,对中度PEM病例评估红细胞内钾缺乏和早期胰岛素释放缺陷是恰当的。必要时应给予补钾。