Department of Critical Care Medicine, West China Hospital, Sichuan University, China.
Department of Critical Care Medicine, West China Hospital, Sichuan University, China.
Med Hypotheses. 2018 Mar;112:37-39. doi: 10.1016/j.mehy.2018.01.010. Epub 2018 Feb 2.
Abnormal glucose levels damage the central nervous system, especially in case of rapid fluctuations. Even a single episode of glucose reperfusion can result in overt impairment of neurons. Oxidative stress plays an important role in this process, sharing properties with the pathophysiologic changes of glucose neurotoxicity. Glucose transporters (GLUTs) located in the brain are involved in direct glucose uptake by neurons. Instead of being insulin-sensitive, these transporters are regulated by glucose levels in the extracellular fluid, increasing their expression while glucose levels fall, to absorb more glucose. Therefore, we hypothesized that mismatch between altered GLUTs and sudden glucose level changes is responsible for neuronal damage during glucose fluctuations. Modulating hypoglycemia by increasing blood glucose slowly may improve the neurological outcomes of hypoglycemia.
异常的血糖水平会损害中枢神经系统，尤其是在血糖快速波动的情况下。即使是单次的血糖再灌注也会导致神经元明显受损。氧化应激在这个过程中起着重要作用，它与葡萄糖神经毒性的病理生理变化具有共同特性。位于大脑中的葡萄糖转运蛋白 (GLUTs) 参与神经元的直接葡萄糖摄取。这些转运蛋白不受胰岛素调控，而是由细胞外液中的葡萄糖水平调节，当血糖下降时，它们的表达增加，以吸收更多的葡萄糖。因此，我们假设在血糖波动期间，改变的 GLUTs 和突然的血糖水平变化之间的不匹配是导致神经元损伤的原因。通过缓慢增加血糖来调节低血糖可能会改善低血糖的神经学结局。
