Hossdorf T, Wagner M, Hoppe H W
Medical University Clinic, Department B, Westfälische Wilhelms-Universität Münster, FRG.
Hepatogastroenterology. 1988 Oct;35(5):238-41.
Nineteen type I diabetics and 15 healthy subjects were given 500 ml of a mixed liquid test meal (flüssige Diabetikerkost, Fresenius, FRG) orally. Furthermore, heart rate variation during deep breathing and Valsalva maneuver was performed in order to test vagus nerve function. PP serum levels were determined before, and 2 to 160 minutes after finishing, the meal. In healthy subjects and in 10 diabetics without any sign of autonomic neuropathy of the vagus nerve a significant rise in PP serum values after the meal could be detected. In 7 type I diabetics with autonomic cardiac neuropathy (abnormal beat-to-beat variation during deep breathing and during the Valsalva maneuver) post-prandial PP levels remained low. Two diabetics without autonomic neuropathy were excluded from the test because endogenic PP antibodies were found in their serum. PP secretion after ingestion of a mixed protein-rich meal is mostly mediated by the vagus nerve or by the extravagal cholinergic system. After vagotomy, no PP secretion after a mixed meal could be detected. Measuring PP serum levels in diabetics after a mixed meal can be useful to check vagus nerve function in the gastrointestinal tract in order to detect autonomic neuropathy.
给19名I型糖尿病患者和15名健康受试者口服500毫升混合液体测试餐（液体糖尿病患者饮食，费森尤斯公司，联邦德国）。此外，进行深呼吸和瓦尔萨尔瓦动作期间的心率变异性检测，以测试迷走神经功能。在进餐前以及进餐后2至160分钟测定血清胰多肽（PP）水平。在健康受试者以及10名无迷走神经自主神经病变迹象的糖尿病患者中，餐后血清PP值显著升高。在7名患有自主神经性心脏病变（深呼吸和瓦尔萨尔瓦动作期间逐搏变化异常）的I型糖尿病患者中，餐后PP水平仍然较低。两名无自主神经病变的糖尿病患者被排除在测试之外，因为在他们的血清中发现了内源性PP抗体。摄入富含蛋白质的混合餐后的PP分泌大多由迷走神经或迷走外胆碱能系统介导。迷走神经切断术后，混合餐后检测不到PP分泌。检测糖尿病患者混合餐后的血清PP水平有助于检查胃肠道的迷走神经功能，以发现自主神经病变。
