Pradat Pierre-Francois, Bruneteau Gaelle, Gordon Paul H, Dupuis Luc, Bonnefont-Rousselot Dominique, Simon Dominique, Salachas Francois, Corcia Philippe, Frochot Vincent, Lacorte Jean-Marc, Jardel Claude, Coussieu Christiane, Le Forestier Nadine, Lacomblez Lucette, Loeffler Jean-Philippe, Meininger Vincent
APHP, Hôpital de la Pitié-Salpêtrière, Fédération des Maladies du Système Nerveux, Paris, France.
Amyotroph Lateral Scler. 2010;11(1-2):166-71. doi: 10.3109/17482960902822960.
Our objectives were to analyse carbohydrate metabolism in a series of ALS patients and to examine potential association with parameters of lipid metabolism and clinical features. Glucose tolerance was assessed by the oral glucose tolerance test in 21 non-diabetic ALS patients and compared with 21 age- and sex-matched normal subjects. Lipids and lactate/pyruvate ratio, levels of pro-inflammatory cytokines (tumour necrosis factor-alpha and interleukin-6) and adipocytokines (leptin and adiponectin) were also measured in ALS patients. Mann-Whitney U-tests analysed continuous data and Fisher's exact tests assessed categorical data. Blood glucose determined 120 min after the glucose bolus was significantly higher in patients with ALS (7.41 mmol/l+/-1.68) compared to controls (6.05+/-1.44, p=0.006). ALS patients with impaired glucose tolerance (IGT) according to WHO criteria (n=7, 33%) were more likely to have elevated free fatty acids (FFA) levels compared to patients with normal glucose tolerance (0.77 nmol/l+/-0.30 vs. 0.57+/-0.19, p=0.04). IGT was not associated with disease duration or severity. In conclusion, patients with ALS show abnormal glucose tolerance that could be associated with increased FFA levels, a key determinant of insulin resistance. The origin of glucose homeostasis abnormalities in ALS may be multifactorial and deserves further investigation.
我们的目标是分析一系列肌萎缩侧索硬化症（ALS）患者的碳水化合物代谢情况，并研究其与脂质代谢参数和临床特征之间的潜在关联。通过口服葡萄糖耐量试验对21例非糖尿病ALS患者的葡萄糖耐量进行评估，并与21例年龄和性别匹配的正常受试者进行比较。同时，还测量了ALS患者的脂质、乳酸/丙酮酸比值、促炎细胞因子（肿瘤坏死因子-α和白细胞介素-6）以及脂肪细胞因子（瘦素和脂联素）的水平。采用曼-惠特尼U检验分析连续数据，采用费舍尔精确检验评估分类数据。与对照组（6.05±1.44，p=0.006）相比，ALS患者在葡萄糖推注后120分钟测定的血糖显著更高（7.41 mmol/l±1.68）。根据世界卫生组织标准，葡萄糖耐量受损（IGT）的ALS患者（n=7，33%）与葡萄糖耐量正常的患者相比，游离脂肪酸（FFA）水平升高的可能性更大（0.77 nmol/l±0.30对0.57±0.19，p=0.04）。IGT与疾病持续时间或严重程度无关。总之，ALS患者表现出异常的葡萄糖耐量，这可能与FFA水平升高有关，FFA是胰岛素抵抗的关键决定因素。ALS患者葡萄糖稳态异常的原因可能是多因素的，值得进一步研究。
