Impacts of the Great East Japan Earthquake on diabetic patients.
Impacts of the Great East Japan Earthquake on diabetic patients.
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DOI：
10.1111/jdi.12336
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发表时间：
2015-09
影响因子：
3.2
通讯作者：
Katagiri H
中科院分区：
文献类型：
--
作者：
Tanaka M;Imai J;Satoh M;Hashimoto T;Izumi T;Sawada S;Uno K;Hasegawa Y;Kaneko K;Yamada T;Ishigaki Y;Imai Y;Katagiri H
我们调查了东日本大地震对糖尿病患者的影响，并描述了易受灾害影响的糖尿病患者。我们招募了497名糖尿病患者，他们在灾区的医院接受了随访。我们前瞻性地收集了地震后1个月和3个月的代谢参数，并回顾性地收集了地震前时间点的代谢参数。问卷调查进行了地震相关的损害和地震后的生活方式的改变。现有数据进行了分析，以检查与地震后糖化血红蛋白改变的关联。受试者的平均糖化血红蛋白水平在1个月时没有升高，在3个月时与震前糖化血红蛋白水平相比显著降低。根据问卷调查获得的数据，血糖控制改善组和血糖控制恶化组之间在地震相关损害或生活方式改变方面没有显著差异。据报道，血糖控制恶化组的空腹血清C肽水平显著降低（P <0.05）。值得注意的是，血糖控制恶化组的血浆去甲肾上腺素水平显著较高（P <0.05）。此外，在震后1个月，低C肽组（空腹血清C肽<1.0 ng/mL）血浆去甲肾上腺素水平显著高于高C肽组（空腹血清C肽≥ 1.0 ng/mL），但这种差异在震后3个月时消失。这些发现表明，地震后血浆去甲肾上腺素水平暂时增加低C肽组。内源性胰岛素分泌能力较低的受试者可能更容易诱发交感神经激活，并可能参与地震后血糖控制恶化的机制。
We investigated impacts of the Great East Japan Earthquake on diabetic patients and characterized those with disaster-susceptible diabetes. We enrolled 497 diabetic patients who had been followed at hospitals in devastated areas. We collected metabolic parameters prospectively, 1 and 3 months after the earthquake, and retrospectively for pre-earthquake time-points. Questionnaire surveys were carried out regarding earthquake-related damage and post-earthquake lifestyle alterations. Available data were analyzed to examine associations with post-earthquake glycosylated hemoglobin alterations. The mean glycosylated hemoglobin level of the participants was not elevated at 1 month, and was significantly decreased at 3 months as compared with the pre-earthquake glycosylated hemoglobin. There were no significant differences in earthquake-related damage or lifestyle alterations between the improved and worsened glycemic control groups according to the data obtained from the questionnaire survey. As reported, fasting serum C-peptide levels were significantly lower in the worsened glycemic control group (P < 0.05). Notably, plasma noradrenaline levels were significantly higher in the worsened glycemic control group (P < 0.05). Furthermore, at 1 month after the earthquake, the plasma noradrenaline level was significantly higher in the low C-peptide group (fasting serum C-peptide <1.0 ng/mL) than in the high C-peptide group (fasting serum C-peptide ≥1.0 ng/mL), but this difference had disappeared by 3 months after the earthquake. These findings show that post-earthquake plasma noradrenaline levels were temporarily increased in the low C-peptide group. Sympathetic nerve activation might be elicited more easily in subjects with lower endogenous insulin secretory capacity, and could be involved in the mechanism underlying post-earthquake worsening of glycemic control.