HUMAN DIABETIC ENDONEURIAL SORBITOL, FRUCTOSE, AND MYOINOSITOL RELATED TO SURAL NERVE MORPHOMETRY
HUMAN DIABETIC ENDONEURIAL SORBITOL, FRUCTOSE, AND MYOINOSITOL RELATED TO SURAL NERVE MORPHOMETRY
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DOI：
10.1002/ana.410080608
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发表时间：
1980-01-01
影响因子：
11.2
通讯作者：
SWANSON, CJ
中科院分区：
文献类型：
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作者：
DYCK, PJ;SHERMAN, WR;SWANSON, CJ
采用生化和病理技术对20例糖尿病患者（多数为成熟型糖尿病）的腓肠神经束进行了研究，并将结果与15名健康人的神经标本进行了比较。山梨醇和果糖含量在糖尿病中比在健康神经中变化更大。超过三分之一的糖尿病神经的山梨醇和果糖含量高于对照组的最高水平。糖尿病神经中肌醇和肌醇含量没有降低。山梨醇、果糖和肌醇浓度与神经病变的临床、神经生理或病理严重程度无关。将记分的症状和体征以及临床神经生理学研究与腓肠神经的形态测量学和戏弄纤维研究进行比较，表明前三种方法提供了敏感可靠的神经病变严重程度测量方法，可用于糖尿病神经病变的对照临床试验。戏弄纤维异常的存在和类型可能与糖尿病的持续时间和神经病变的症状有关。在没有神经病变症状的未经治疗的糖尿病患者中，戏弄纤维的频率高于正常水平，显示节段性脱髓鞘和再脱髓鞘。伴有症状性神经病变的未经治疗的糖尿病患者表现出两种异常：纤维有节段性脱髓鞘和再髓鞘，纤维发生轴突变性。在长期神经病变的糖尿病患者中，最常见的异常是纤维轴突变性。
Fascicles of the sural nerve from each of 20 diabetic patients, mostly with maturity‐onset diabetes, were studied by biochemical and pathological techniques, and results were compared to values found in nerve specimens from 15 healthy persons. The sorbitol and fructose content was much more variable in diabetic than in healthy nerves. More than one‐third of the diabetic nerves had sorbitol and fructose values above the highest levels for controls.myo‐Inositol andscyllo‐inositol content was not reduced in diabetic nerves. The sorbitol, fructose, and inositol concentrations could not be related to clinical, neurophysiological, or pathological severity of neuropathy. A comparison of scored symptoms and signs and clinical neurophysiological studies against morphometric and teased fiber studies of sural nerve demonstrated that the former three provide sensitive and reliable measures of severity of neuropathy that can be used for controlled clinical trials of diabetic neuropathy. The presence and type of teased fiber abnormalities could be related to the duration of diabetes and to symptoms of neuropathy. In untreated diabetics without symptoms of neuropathy, a higher than normal frequency of teased fibers showing segmental demyelination and remyelination was found. Untreated diabetics with symptomatic neuropathy showed two kinds of abnormalities: fibers with segmental demyelination and remyelination and fibers undergoing axonal degeneration. In treated diabetics, who often had longstanding neuropathy, the most common abnormalities were fibers undergoing axonal degeneration.