Dekker E, Romijn J A, Waruiru C, Ackermans M T, Weverling G J, Sauerwein R W, Endert E, Peshu N, Marsh K, Sauerwein H P
Department of Endocrinology and Metabolism, University of Amsterdam, The Netherlands.
Trans R Soc Trop Med Hyg. 1996 Nov-Dec;90(6):654-7. doi: 10.1016/s0035-9203(96)90422-8.
The pathophysiology of hypoglycaemia in children with acute falciparum malaria, a frequent and serious complication, is unknown due to absence of data on glucose kinetics. We investigated the correlation between basal glucose production and plasma glucose concentration in 20 children (8 girls) with acute, uncomplicated falciparum malaria by infusion of [6,6-2H2]glucose. Median plasma glucose concentration was 4.5 (range 2.1-6.5) mmol/L and the median glucose production 5.0 (range 4.1-8.4) mg/kg/min. There was a positive correlation between basal glucose production and plasma glucose concentration (r = 0.53, P = 0.016). There was no correlation between the rate of glucose production and the plasma concentrations of alanine, lactate, counter-regulatory hormones or cytokines. It was concluded that, in children with acute uncomplicated falciparum malaria, endogenous glucose production is an important determinant of plasma glucose concentration, contrary to previous findings in adults with malaria, in whom peripheral uptake seems to be more important than glucose production in determining plasma glucose concentration.
低血糖是急性恶性疟患儿常见且严重的并发症，由于缺乏葡萄糖动力学数据，其病理生理学尚不清楚。我们通过输注[6,6-2H2]葡萄糖，研究了20名（8名女孩）患急性非复杂性恶性疟患儿的基础葡萄糖生成与血浆葡萄糖浓度之间的相关性。血浆葡萄糖浓度中位数为4.5（范围2.1 - 6.5）mmol/L，葡萄糖生成中位数为5.0（范围4.1 - 8.4）mg/kg/min。基础葡萄糖生成与血浆葡萄糖浓度之间存在正相关（r = 0.53，P = 0.016）。葡萄糖生成速率与丙氨酸、乳酸、反调节激素或细胞因子的血浆浓度之间无相关性。得出的结论是，在患急性非复杂性恶性疟的儿童中，内源性葡萄糖生成是血浆葡萄糖浓度的重要决定因素，这与先前在患疟疾成人中的发现相反，在后者中，外周摄取在决定血浆葡萄糖浓度方面似乎比葡萄糖生成更重要。
