Department of Neuroscience, S. Giovanni di Dio Hospital, Crotone, Italy.
Acta Neurol Scand. 2011 Jan;123(1):68-72. doi: 10.1111/j.1600-0404.2010.01365.x.
Idiopathic peripheral facial nerve palsy or Bell's palsy (BP) is the most common cause of facial nerve palsy.
To evaluate the role of glucose metabolism abnormalities in BP.
We identified 148 patients with unilateral BP and 128 control subjects. In all we evaluated glucose level at fasting and after a 2-h oral glucose tolerance test (2h-OGTT). In addition we determined insulin resistance (IR), by HOMA-index. Patients and controls were divided in to two groups, according to their Body Mass Index (BMI).
Following a 2h-OGTT, the prevalence of glucose metabolism abnormalities was significantly higher in patients with BP than in controls (P < 0.001). Impaired glucose tolerance (IGT) was found in 57 (38%) patients and in 23 (18%) controls, while a new-diagnosed DM (NDDM) was found in 29 (19%) patients and in 8 (6%) controls. The IR was significantly increased only in BP patients with BMI ≥ 24.9 (P = 0.005). BMI, waist circumference, blood pressure, tryglicerides, serum lipid, drugs use were not significantly different between patients and controls.
In this study we found that prediabetes is frequently associated with facial palsy. We propose to perform a 2h-OGTT in patients with peripheral facial palsy and normal fasting glycaemia. HOMA-index should be evaluated in obese facial palsy patients.
特发性周围性面神经麻痹或贝尔麻痹(BP)是面神经麻痹最常见的原因。
评估葡萄糖代谢异常在 BP 中的作用。
我们确定了 148 例单侧 BP 患者和 128 例对照。在所有患者中,我们评估了空腹和 2 小时口服葡萄糖耐量试验(2h-OGTT)后血糖水平。此外,我们通过 HOMA 指数确定了胰岛素抵抗(IR)。根据患者和对照的体重指数(BMI),将患者和对照分为两组。
在 2h-OGTT 后,BP 患者葡萄糖代谢异常的患病率明显高于对照组(P<0.001)。57 例(38%)患者出现糖耐量受损(IGT),23 例(18%)对照出现糖耐量受损(IGT),29 例(19%)患者出现新诊断的糖尿病(NDDM),8 例(6%)对照出现新诊断的糖尿病(NDDM)。只有 BMI≥24.9 的 BP 患者的 IR 显著增加(P=0.005)。BP 患者和对照之间的 BMI、腰围、血压、甘油三酯、血脂、药物使用无显著差异。
在这项研究中,我们发现糖尿病前期与面瘫常有相关性。我们建议在周围性面瘫患者中进行 2h-OGTT。在肥胖的面瘫患者中,应评估 HOMA 指数。