Hyponatremia: Evaluating the correction factor for hyperglycemia
Hyponatremia: Evaluating the correction factor for hyperglycemia
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DOI：
10.1016/s0002-9343(99)00055-8
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发表时间：
1999-04-01
影响因子：
5.9
通讯作者：
Barrett, EJ
中科院分区：
文献类型：
--
作者：
Hillier, TA;Abbott, RD;Barrett, EJ
目得：没有对照实验数据评估常用校正因子（血糖浓度每增加100 mg/dL，血清钠浓度降低1.6 meq/L）的准确性。本研究的目的是评估实验性低钠反应急性glycemic.SubJECTS和方法：输注生长抑素阻断内源性胰岛素分泌在6名健康受试者。通过输注20%葡萄糖，血浆葡萄糖浓度在1小时内增加至>600 mg/dL。然后停止葡萄糖输注，并给予胰岛素，直至血糖浓度降至140 mg/dL。血浆葡萄糖和血清钠浓度测定每10 minutes.RESULTS：总体而言，平均降低血清钠浓度平均为2.4 meq/L，每100 mg/dL的葡萄糖浓度增加。该值显著大于常用的校正因子1.6（P = 0.02）。此外，钠和葡萄糖浓度之间的关联是非线性的。这在葡萄糖浓度>400 mg/dL时最为明显。在400 mg/dL以下，1.6的标准校正效果良好，但如果葡萄糖浓度>400 mg/dL，则校正因子为4.0更好。这些数据表明，钠浓度的生理性降低显著大于标准校正因子1.6（meq/L Na/100 mg/dL葡萄糖），尤其是当葡萄糖浓度>400 mg/dL时。此外，葡萄糖浓度每增加100 mg/dL，钠浓度降低2.4 meq/L的校正因子是比通常校正因子1.6更好的这种关联的总体估计。(C)1999年，Excerpta Medica，Inc.
PURPOSE: There are no controlled experimental data that assess the accuracy of the commonly used correction factor of a 1.6 meq/L decrease in serum sodium concentration for every 100 mg/dL increase in plasma glucose concentration. The purpose of this study was to evaluate experimentally the hyponatremic response to acute hyperglycemia.SUBJECTS AND METHODS: Somatostatin was infused to block endogenous insulin secretion in 6 healthy subjects. Plasma glucose concentrations were increased to >600 mg/dL within 1 hour by infusing 20% dextrose. The glucose infusion was then stopped and insulin given until the plasma glucose concentration decreased to 140 mg/dL. Plasma glucose and serum sodium concentrations were measured every 10 minutes.RESULTS: Overall, the mean decrease in serum sodium concentration averaged 2.4 meq/L for every 100 mg/dL increase in glucose concentration. This value is significantly greater than the commonly used correction factor of 1.6 (P = 0.02). Moreover, the association between sodium and glucose concentrations was nonlinear. This was most apparent for glucose concentrations >400 mg/dL. Up to 400 mg/dL, the standard correction of 1.6 worked well, but if the glucose concentration was >400 mg/dL, a correction factor of 4.0 was better.CONCLUSION: These data indicate that the physiologic decrease in sodium concentration is considerably greater than the standard correction factor of 1.6 (meq/L Na per 100 mg/dL glucose), especially when the glucose concentration is >400 mg/dL. Additionally, a correction factor of a 2.4 meq/L decrease in sodium concentration per 100 mg/dL increase in glucose concentration is a better overall estimate of this association than the usual correction factor of 1.6. (C) 1999 by Excerpta Medica, Inc.