Barnes A J, Kohner E M, Johnston D G, Alberti K G
Lancet. 1985 Jun 29;1(8444):1465-8. doi: 10.1016/s0140-6736(85)92250-0.
8 patients with severe progressive diabetic retinopathy despite continued mild carbohydrate intolerance on diet therapy alone were studied; each patient had presented initially with visual deterioration and none had experienced hyperglycaemic symptoms. By comparison with 8 carefully matched diet-treated diabetics without retinopathy, the retinopathy patients had increased circulating growth hormone levels and relative insulin deficiency. Several other factors of possible importance in the aetiology of microangiopathy, including circulating intermediary metabolites, platelet aggregation, blood viscosity, and lipids were similar in the two groups. It is possible that hypoinsulinaemia together with growth hormone excess may contribute to the development of eye disease in these patients with otherwise mild diabetes.
对8例尽管仅通过饮食治疗仍存在轻度碳水化合物不耐受但患有严重进行性糖尿病视网膜病变的患者进行了研究；每位患者最初均出现视力下降，且均未出现高血糖症状。与8例精心匹配的无视网膜病变的饮食治疗糖尿病患者相比，视网膜病变患者的循环生长激素水平升高且存在相对胰岛素缺乏。两组中其他一些可能在微血管病变病因中具有重要意义的因素，包括循环中间代谢产物、血小板聚集、血液粘度和血脂，均相似。低胰岛素血症与生长激素过多共同作用可能促使这些患有轻度糖尿病的患者发生眼部疾病。
