Kawahito Shinji, Kitahata Hiroshi, Oshita Shuzo
Department of Anesthesiology, Tokushima University Medical and Dental Hospital, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
World J Gastroenterol. 2009 Sep 7;15(33):4137-42. doi: 10.3748/wjg.15.4137.
Glucose homeostasis deficiency leads to a chronic increase in blood glucose concentration. In contrast to physiological glucose concentration, chronic superphysiological glucose concentration negatively affects a large number of organs and tissues. Glucose toxicity means a decrease in insulin secretion and an increase in insulin resistance due to chronic hyperglycemia. It is now generally accepted that glucose toxicity is involved in the worsening of diabetes by affecting the secretion of beta-cells. Several mechanisms have been proposed to explain the adverse effects of hyperglycemia. It was found that persistent hyperglycemia caused the functional decline of neutrophils. Infection is thus the main problem resulting from glucose toxicity in the acute phase. In other words, continued hyperglycemia is a life-threatening risk factor, not only in the chronic but also the acute phase, and it becomes a risk factor for infection, particularly in the perioperative period.
葡萄糖稳态缺乏会导致血糖浓度持续升高。与生理血糖浓度相比，长期处于超生理血糖浓度会对大量器官和组织产生负面影响。葡萄糖毒性是指由于慢性高血糖导致胰岛素分泌减少和胰岛素抵抗增加。目前普遍认为，葡萄糖毒性通过影响β细胞分泌而参与糖尿病的病情恶化。已经提出了几种机制来解释高血糖的不良影响。研究发现，持续性高血糖会导致中性粒细胞功能下降。因此，感染是急性期葡萄糖毒性导致的主要问题。换句话说，持续高血糖不仅在慢性期而且在急性期都是危及生命的危险因素，并且它成为感染的危险因素，尤其是在围手术期。
