Günöz H, Dindar A, Neyzi O
Department of Pediatrics, Istanbul Faculty of Medicine, Capa, Turkey.
Diabetes Res Clin Pract. 1994 Jun;24(2):97-101. doi: 10.1016/0168-8227(94)90026-4.
The levels of beta-endorphin, insulin, cortisol, GH, glucagon, prolactin and TSH were measured in serum samples of 9 hyperglycaemic patients (3 female, 6 male) with a mean age of 4.1 years admitted to the pediatric emergency unit. All patients were in acute stress due to severe diseases (acute gastroenteritis, bronchopneumonia, septicaemia, etc.). Initial and repeat blood samples for hormone determination were taken at admission and in the recovery phase (after 4-6 weeks of treatment). OGTT was also performed in the recovery phase. The hyperglycaemia, monitored hourly following the initial determination, returned to normal in all patients in 1-5 h without specific treatment. Mean serum glucose values at admission and in the recovery phase were 287.0 and 84.1 mg/dl. Concomitant to the hyperglycaemia encountered in these patients in the acute phase of stress, an increase was noted in all hormone levels excluding glucagon and cortisol. All elevated hormone levels fell to normal in 4-6 weeks with significant differences from initial levels for beta-endorphin (P < 0.05) and insulin (P < 0.01). OGTT gave a normal curve. These results indicate that stress hyperglycaemia, despite high insulin levels, is associated with an increase in beta-endorphin levels. The results also show that hyperglycaemia in acute disease does not alter OGTT in short-term follow up.
对收入儿科急诊室的9名高血糖患者(3名女性,6名男性)的血清样本进行了β-内啡肽、胰岛素、皮质醇、生长激素、胰高血糖素、催乳素和促甲状腺激素水平的检测。这些患者的平均年龄为4.1岁,均因严重疾病(急性肠胃炎、支气管肺炎、败血症等)处于急性应激状态。在入院时和恢复阶段(治疗4 - 6周后)采集用于激素测定的初始血样和重复血样。在恢复阶段还进行了口服葡萄糖耐量试验(OGTT)。在首次测定后每小时监测一次高血糖情况,所有患者在未进行特殊治疗的情况下,1 - 5小时内高血糖恢复正常。入院时和恢复阶段的平均血清葡萄糖值分别为287.0和84.1mg/dl。与这些患者在应激急性期出现的高血糖同时发生的是,除胰高血糖素和皮质醇外,所有激素水平均升高。所有升高的激素水平在4 - 6周内降至正常,β-内啡肽(P < 0.05)和胰岛素(P < 0.01)与初始水平有显著差异。OGTT呈现正常曲线。这些结果表明,尽管胰岛素水平较高,但应激性高血糖与β-内啡肽水平升高有关。结果还表明,急性疾病中的高血糖在短期随访中不会改变OGTT。