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首页> 外文期刊>Cytokine >Decreased vascular endothelial growth factor response to acute hypoglycemia in type 2 diabetic patients with hypoglycemic coma
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Decreased vascular endothelial growth factor response to acute hypoglycemia in type 2 diabetic patients with hypoglycemic coma

机译：2型糖尿病低血糖昏迷患者对急性低血糖的血管内皮生长因子应答降低

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Introduction: Plasma vascular endothelial growth factor (VEGF) was shown to increase during acute hypoglycemia and could mediate rapid adaptation of the brain. In this study we examined the neuroendocrine response in patients with type 2 diabetes mellitus (T2DM) in hypoglycemic coma or with acute neuroglycopenic symptoms. Methods: We prospectively studied 135 consecutive T2DM patients admitted for severe hypoglycemia during a 2-year period. We collected clinical variables and measured plasma concentrations of VEGF, epinephrine, norepinephrine, cortisol and growth hormone at admission and 30. min afterwards. Results: Thirty two patients developed hypoglycemic coma and 103 did not lose consciousness. Median plasma VEGF level of coma patients was 3.1-fold lower at baseline than that of non-coma patients, and even 5.3-fold lower 30. min afterwards. Plasma epinephrine concentration was significantly lower just at baseline in coma patients. On the contrary, there were no differences in concentrations of the other hormones. Multivariate logistic regression analysis showed that VEGF concentration (OR 0.68; CI 0.51-0.95) was a protective factor against the development of coma. Conclusions: VEGF and epinephrine responses to acute hypoglycemia are reduced in T2DM patients who develop hypoglycemic coma. An increased plasma VEGF concentration appeared to be a protective factor against the development of hypoglycemic coma.
机译：简介：血浆血管内皮生长因子（VEGF）在急性低血糖症中表现出增加，并且可以介导大脑的快速适应。在这项研究中，我们检查了患有低血糖昏迷或急性神经血糖症状的2型糖尿病（T2DM）患者的神经内分泌反应。方法：我们前瞻性研究了2年内连续135例因严重低血糖而入院的T2DM患者。我们收集了临床变量并在入院时和入院后30分钟测量了VEGF，肾上腺素，去甲肾上腺素，皮质醇和生长激素的血浆浓度。结果：32例患者出现了低血糖昏迷，103例没有失去知觉。昏迷患者的血浆中位数VEGF水平在基线时比非昏迷患者低3.1倍，甚至在30分钟后降低5.3倍。在昏迷患者中，血浆肾上腺素浓度显着降低。相反，其他激素的浓度没有差异。多元logistic回归分析表明，VEGF浓度（OR 0.68; CI 0.51-0.95）是预防昏迷的保护因子。结论：发生低血糖昏迷的T2DM患者降低了VEGF和肾上腺素对急性低血糖的反应。血浆VEGF浓度升高似乎是抵抗低血糖昏迷发展的保护因素。

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