Ueno Hiroaki, Shiiya Tomomi, Nagamine Kazuhiro, Tsuchimochi Wakaba, Sakoda Hideyuki, Shiomi Kazutaka, Kangawa Kenji, Nakazato Masamitsu
Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan.
National Cardiovascular Center Research Institute, Osaka 565-8565, Japan.
Endocr J. 2017;64(Suppl.):S53-S57. doi: 10.1507/endocrj.64.S53.
Diabetic peripheral neuropathy (DPN) is the most common complication of diabetes, and its progression significantly worsens the patient's quality of life. Although several drugs are available for DPN, all of these provide only symptomatic relief. We investigated the therapeutic effects of ghrelin for DPN, based on its various physiological functions. Seven patients with type 2 diabetes with typical clinical signs and symptoms of DPN were hospitalized. Synthetic human ghrelin (1.0 μg/kg) was administered intravenously for 14 days. Motor nerve conduction velocity (MCV) of the posterior tibial nerve improved significantly after the treatment, compared to that at baseline (35.1 ± 1.8 to 38.6 ± 1.8 m/s, p < 0.0001), while the MCV in six untreated patients did not change throughout hospitalization. The subjective symptoms assessed based on the total symptom score also significantly improved (15.6 ± 3.1 to 11.1 ± 2.2, p = 0.047). Although sensory nerve conduction velocity (SCV) of the sural nerve could not be detected in three patients at baseline, it was detected in two of the three patients after 14 days of ghrelin administration. Overall, SCV did not change significantly. Plasma glucose, but not serum C peptide, levels during a liquid meal tolerance test significantly improved after treatment. These results suggest that ghrelin may be a novel therapeutic option for DPN; however, a double-blind, placebo-controlled trial is needed in the future.
糖尿病周围神经病变（DPN）是糖尿病最常见的并发症，其进展会显著恶化患者的生活质量。虽然有几种药物可用于治疗DPN，但所有这些药物都只能缓解症状。基于生长激素释放肽的多种生理功能，我们研究了其对DPN的治疗效果。7例患有2型糖尿病且有典型DPN临床症状和体征的患者住院治疗。静脉注射合成人生长激素释放肽（1.0μg/kg），持续14天。治疗后，胫后神经的运动神经传导速度（MCV）较基线时显著改善（从35.1±1.8米/秒提高到38.6±1.8米/秒，p<0.0001），而6例未治疗患者的MCV在整个住院期间未发生变化。基于总症状评分评估的主观症状也显著改善（从15.6±3.1降至11.1±2.2，p=0.047）。虽然在基线时3例患者的腓肠神经感觉神经传导速度（SCV）无法检测到，但在给予生长激素释放肽14天后，其中2例患者的SCV可以检测到。总体而言，SCV没有显著变化。治疗后，液体餐耐量试验期间的血浆葡萄糖水平显著改善，但血清C肽水平未改善。这些结果表明，生长激素释放肽可能是DPN的一种新的治疗选择；然而，未来需要进行双盲、安慰剂对照试验。
