Graf R J, Halter J B, Halar E, Porte D
Ann Intern Med. 1979 Mar;90(3):298-303. doi: 10.7326/0003-4819-90-3-298.
The role of metabolic abnormalities in the development of diabetic neuropathy is controversial. To investigate the influence of hyperglycemia on nerve conduction, we studied 20 untreated maturity-onset diabetic patients and 23 normal control subjects of similar age. Nerve conduction velocity of motor (median, peroneal, and tibial) and sensory (median and sural) nerves in diabetic patients was significantly slowed and H-reflex latency time prolonged. Levels of fasting plasma glucose in diabetic subjects were correlated with slowed motor conduction velocity of the median, peroneal, and tibial nerves but not with sensory nerve conduction velocities. Levels of glycosylated hemoglobin, an index of long-term glycemia, were correlated with slowing of peroneal motor conduction velocity in diabetic patients. These associations could not be explained by patient age or duration of diabetes. These findings suggest that the degree of hyperglycemia of untreated maturity-onset diabetes contributes to the motor nerve conduction abnormalities in this disease.
代谢异常在糖尿病神经病变发展中的作用存在争议。为研究高血糖对神经传导的影响,我们对20例未经治疗的成年起病糖尿病患者和23名年龄相仿的正常对照者进行了研究。糖尿病患者运动神经(正中神经、腓总神经和胫神经)和感觉神经(正中神经和腓肠神经)的神经传导速度显著减慢,H反射潜伏期延长。糖尿病患者空腹血糖水平与正中神经、腓总神经和胫神经运动传导速度减慢相关,但与感觉神经传导速度无关。糖化血红蛋白水平(长期血糖指标)与糖尿病患者腓总神经运动传导速度减慢相关。这些关联无法用患者年龄或糖尿病病程来解释。这些发现表明,未经治疗的成年起病糖尿病的高血糖程度促成了该疾病中的运动神经传导异常。