Hamed Sherifa, Metwalley Kotb Abbass, Farghaly Hekma Saad, Sherief Tahra
1 Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt.
2 Department of Pediatrics, Assiut University Children's Hospital, Assiut, Egypt.
J Child Neurol. 2017 Apr;32(5):475-481. doi: 10.1177/0883073816686718. Epub 2017 Jan 5.
Neuron-specific enolase is a sensitive marker of neuronal damage in various neurologic disorders. This study aimed to measure serum neuron-specific enolase levels at different time points and severities of diabetic ketoacidosis. This study included 90 children (age 9.2 ± 3.4 years) with diabetic ketoacidosis. Neuron-specific enolase was measured at 3 time points (baseline and after 12 and 24 hours of starting treatment). Among patients, 74.4% had diagnosis of new diabetes, 60% had Glasgow Coma Scale score <15, and 75.6% had moderate/severe diabetic ketoacidosis. Compared with controls (n = 30), children with diabetic ketoacidosis had higher neuron-specific enolase levels at the 3 time points ( P = .0001). In multiple regression analysis, the factors associated with higher neuron-specific enolase levels were younger age, higher glucose, lower pH, and bicarbonate values. This study indicates that serum neuron-specific enolase is elevated in diabetic ketoacidosis and correlated with the severity of hyperglycemia, ketosis, and acidosis. This study indicates that diabetic ketoacidosis may cause neuronal injury from which the patients recovered partially but not completely.
神经元特异性烯醇化酶是各种神经系统疾病中神经元损伤的敏感标志物。本研究旨在测量糖尿病酮症酸中毒不同时间点及严重程度时的血清神经元特异性烯醇化酶水平。本研究纳入了90例糖尿病酮症酸中毒患儿（年龄9.2±3.4岁）。在3个时间点（基线以及开始治疗12小时和24小时后）测量神经元特异性烯醇化酶。患者中，74.4%诊断为新发糖尿病，60%格拉斯哥昏迷量表评分<15，75.6%为中度/重度糖尿病酮症酸中毒。与对照组（n = 30）相比，糖尿病酮症酸中毒患儿在3个时间点的神经元特异性烯醇化酶水平更高（P = .0001）。在多元回归分析中，与较高神经元特异性烯醇化酶水平相关的因素为年龄较小、血糖较高、pH值较低和碳酸氢盐值较低。本研究表明，糖尿病酮症酸中毒时血清神经元特异性烯醇化酶升高，且与高血糖、酮症和酸中毒的严重程度相关。本研究表明，糖尿病酮症酸中毒可能导致神经元损伤，患者虽部分恢复但未完全恢复。
