Carrà M, Brambilla P, Meschi F, Mistura L, Bognetti E, Malesci A, Bonato C, Bocchia P, Chiumello G
Istituto Scientifico H. San Raffaele, Clinica Pediatrica 3o, Milano, Italy.
Acta Diabetol Lat. 1990 Apr-Jun;27(2):165-71. doi: 10.1007/BF02581288.
An impaired pancreatic polypeptide response (PP) after hypoglycemia has been described in type I diabetic patients with overt autonomic neuropathy. Some authors have suggested that PP release might be useful as sensitive indicator of autonomic neuropathy. The meal test is safer and simpler than the insulin infusion test as PP stimulus. The aim of this study was to compare PP response to insulin infusion and protein meal test and to correlate these responses to the presence of measurable neuropathic disturbances. We thus studied 13 IDDM children and adolescents and 6 normal children. In diabetics the PP response to both tests was not different from that of the control subjects, but PP response to insulin infusion was inversely correlated to the duration of illness and was significantly lower in subjects with pathological heart rate response when compared to the control group. PP responses to the two stimuli were not correlated. We suggest that reduced PP response to hypoglycemia is an early sign of autonomic neuropathy as well as impairment of beat-to-beat variation when impaired PP response to meal test is still not evident.
在患有明显自主神经病变的I型糖尿病患者中，低血糖后胰腺多肽反应（PP）受损已被描述。一些作者认为，PP释放可能作为自主神经病变的敏感指标。作为PP刺激，进餐试验比胰岛素输注试验更安全、更简单。本研究的目的是比较PP对胰岛素输注和蛋白质进餐试验的反应，并将这些反应与可测量的神经病变紊乱的存在相关联。因此，我们研究了13名IDDM儿童和青少年以及6名正常儿童。在糖尿病患者中，两种试验的PP反应与对照组无差异，但PP对胰岛素输注的反应与病程呈负相关，与对照组相比，心率反应异常的受试者的PP反应显著降低。对两种刺激的PP反应不相关。我们认为，低血糖时PP反应降低是自主神经病变的早期迹象，也是当PP对进餐试验的反应受损仍不明显时逐搏变化受损的表现。
