Dahlquist G, Gentz J, Hagenfeldt L, Larsson A, Löw H, Persson B, Zetterström R
Acta Paediatr Scand. 1979 Sep;68(5):649-56. doi: 10.1111/j.1651-2227.1979.tb18433.x.
We have studied 15 children referred to St. Göran's Children's Hospital because of suspected ketotic hypoglycemia. The patients were investigated according to a program designed to test several hypotheses--old and new--postulated to explain the etiology of ketotic hypoglycemia. We have used the classical ketogenic provocation with a low calorie, high fat diet and measured the blood levels of several substrates and hormones as well as the urinary excretion of certain metabolites and hormones. Out of the 15 children, 6 will fill the criteria of ketotic hypoglycemia at the time of study. The most remarkable finding in these 6 children in contrast to the other children studied was that they did not decrease their peripheral glucose utilization (measured as Kg) during starvation. These 6 children seemed to be more "advanced" in their adaptation to ketogenic diet in all other parameters studied. The children with ketotic hypoglycemia did not differ from the other children in plasma level of cortisol or urinary excretion of nitrogen, urea, 3-methylstidine and catecholamines. We favour the concept that the children with ketotic hypoglycemia represent the tail of the gaussian curve in the normal age-dependent development of the adaptation to starvation.
我们研究了15名因疑似酮症性低血糖症而转诊至圣戈兰儿童医院的儿童。根据一个旨在检验若干用以解释酮症性低血糖症病因的新旧假说的方案，对这些患者进行了调查。我们采用了低热量、高脂肪饮食的经典生酮激发试验，并测量了几种底物和激素的血药浓度以及某些代谢物和激素的尿排泄量。在这15名儿童中，有6名在研究时符合酮症性低血糖症的标准。与其他接受研究的儿童相比，这6名儿童最显著的发现是，他们在饥饿期间并未降低外周葡萄糖利用率（以Kg衡量）。在所有其他研究参数方面，这6名儿童在适应生酮饮食方面似乎更为“先进”。酮症性低血糖症患儿与其他儿童在皮质醇血浆水平或氮、尿素、3-甲基组氨酸和儿茶酚胺的尿排泄量方面并无差异。我们支持这样一种观点，即酮症性低血糖症患儿代表了正常年龄依赖性饥饿适应发育过程中高斯曲线的尾部。
