Prinsloo J G, De Bruin E J, Kruger H
Arch Dis Child. 1971 Dec;46(250):795-800. doi: 10.1136/adc.46.250.795.
Intravenous glucose tolerance tests and serum insulin responses were estimated on admission to hospital as well as after recovery in 16 kwashiorkor and 15 pellagra children. Only the kwashiorkor group showed impairment of glucose utilization on admission, and the glucose disappearance rate of the two groups differed significantly. After clinical recovery the glucose utilization of the kwashiorkor patients was much improved, and similar to that of the pellagra patients. These findings are different from those of others who reported persistent glucose intolerance after kwashiorkor. The glucose tolerance tests were normal in the pellagra group, both on admission and after recovery. The kwashiorkor group's insulin response was less than that of the pellagra group on admission, and the values of the two groups differed significantly at 5, 15, and 30 minutes after glucose administration. After recovery, the insulin levels of the two groups were similar. The improvement in glucose utilization which took place on recovery of the kwashiorkor patients, as well as the low incidence of diabetes mellitus in the Bantu, cast doubt on the concept of permanent impairment of pancreatic endocrine function as a result of protein-calorie-malnutrition. It is speculated that glucose intolerance may be related to body potassium deficiency.
对16名夸休可尔症患儿和15名糙皮病患儿在入院时以及康复后进行了静脉葡萄糖耐量试验和血清胰岛素反应评估。仅夸休可尔症组在入院时显示葡萄糖利用受损，且两组的葡萄糖消失率差异显著。临床康复后，夸休可尔症患者的葡萄糖利用有很大改善，与糙皮病患者相似。这些发现与其他报道夸休可尔症后持续存在葡萄糖不耐受的研究结果不同。糙皮病组在入院时和康复后的葡萄糖耐量试验均正常。夸休可尔症组入院时的胰岛素反应低于糙皮病组，且在给予葡萄糖后5分钟、15分钟和30分钟时两组的值差异显著。康复后，两组的胰岛素水平相似。夸休可尔症患者康复后葡萄糖利用的改善以及班图人中糖尿病的低发病率，对蛋白质 - 热量营养不良导致胰腺内分泌功能永久性损害这一概念提出了质疑。据推测，葡萄糖不耐受可能与体内钾缺乏有关。
