Zijlmans Wilco, van Kempen Anne, Ackermans Mariëtte, de Metz Jesse, Kager Piet, Sauerwein Hans
Department of Pediatrics, Diakonessen Hospital, Paramaribo, Suriname.
Am J Trop Med Hyg. 2008 Oct;79(4):605-12.
Fasting could be an important factor in the induction of hypoglycemia in children with malaria because fasting results in a decrease in endogenous glucose production. The influence of extended fasting on plasma glucose concentration, glucose production, and gluconeogenesis were measured using [6,6-(2)H(2)]glucose and (2)H(2)O in 12 Surinamese children with severe malaria and compared with 16 children with non-severe malaria during a 16-hour controlled fast. Glucose concentration and glucose production were comparable after 8 hours of fasting and decreased in both groups (P < 0.001) with an extension of the fast up to 16 hours. Glucose concentration decreased faster in the non-severe group than in the severe group (P = 0.029). The decrease in glucose production was not different between groups (P = 0.954). Thus, fasting predisposes for hypoglycemia in young children with Plasmodium falciparum malaria. Hypoglycemia caused by fasting develops later in young children with severe malaria than in children with non-severe malaria.
禁食可能是导致疟疾患儿低血糖的一个重要因素，因为禁食会使内源性葡萄糖生成减少。在12名患有严重疟疾的苏里南儿童中，使用[6,6-(2)H(2)]葡萄糖和(2)H(2)O测定了延长禁食对血糖浓度、葡萄糖生成和糖异生的影响，并与16名患有非严重疟疾的儿童在16小时的控制禁食期间进行了比较。禁食8小时后，血糖浓度和葡萄糖生成相当，随着禁食延长至16小时，两组均下降（P < 0.001）。非严重组血糖浓度下降速度比严重组快（P = 0.029）。两组之间葡萄糖生成的下降没有差异（P = 0.954）。因此，禁食易使感染恶性疟原虫的幼儿发生低血糖。禁食引起的低血糖在患有严重疟疾的幼儿中比在患有非严重疟疾的儿童中出现得更晚。
