Delaney C A, Mouser J V, Westerman R A
Department of Physiology, Monash University, Clayton, Victoria.
Clin Exp Neurol. 1994;31:19-37.
The central and peripheral nervous systems do not require insulin for glucose uptake. However, insulin receptors have been detected in these regions. The aim of this study was to examine peripheral sensory nerve function and its dependence on insulin using healthy non-diabetic control subjects, obese individuals, and diabetic (insulin dependent and non-insulin dependent diabetes mellitus) subjects. The results revealed that the warm and cold perception thresholds, reflecting the functional states of unmyelinated C-fibres and A-delta fibres respectively, increased with reduced insulin sensitivity and with increased fasting insulin concentrations. From such data in non-diabetic subjects with measured insulin sensitivity, it appeared that sensory nerve function was disturbed in normoglycemic but insulin resistant states, suggesting that insulin has an action on nervous tissue in addition to its effects on glucose metabolism. The mechanisms of this action remain to be elucidated.
中枢神经系统和外周神经系统摄取葡萄糖不需要胰岛素。然而，已在这些区域检测到胰岛素受体。本研究的目的是利用健康非糖尿病对照受试者、肥胖个体以及糖尿病患者（胰岛素依赖型和非胰岛素依赖型糖尿病）来检测外周感觉神经功能及其对胰岛素的依赖性。结果显示，分别反映无髓鞘C纤维和Aδ纤维功能状态的温觉和冷觉阈值，随着胰岛素敏感性降低和空腹胰岛素浓度升高而增加。从这些具有测量胰岛素敏感性的非糖尿病受试者的数据来看，似乎在血糖正常但胰岛素抵抗的状态下感觉神经功能受到了干扰，这表明胰岛素除了对葡萄糖代谢有影响外，对神经组织也有作用。这种作用的机制仍有待阐明。
