高胰岛素血症与低血钾型周期性麻痹的初步探讨

The Relationship between Hyperinsulinemia and Hypokalemic Periodic Paralysis

目的探讨高胰岛素血症与低血钾型周期性麻痹(HoPP)的关系。方法对48例低血钾型周期性麻痹患者行口服糖耐量实验(OGTT)并测定血糖、胰岛素及血钾,计算胰岛素抵抗指数(IRI)并与正常对照组进行比较。结果低血钾周期性麻痹组OGTT各个时点胰岛素水平[0min(14.11±5.53)mmol/L,30min(121.22±79.96)mmol/L,60min(136.95±68.07)mmol/L,120min(119.13±68.26)mmol/L,180min(52.49±48.53)mmol/L]高于正常对照组[0min(6.78±3.26)mmol/L,30min(60.08±20.53)mmol/L,60min(64.89±24.27)mmol/L,120min(50.77±24.34)mmol/L,180min(19.71±18.82)mmol/L],差别有统计学意义(P<0.05);IRI(0.97±0.53)高于正常对照组(0.09±0.59),差别有统计学意义(P<0.05)。结论低血钾型周期性麻痹患者存在高胰岛素血症,预防和治疗高胰岛素血症有可能成为预防和治疗低血钾周期性麻痹的一项新的治疗途径。

Objective To investigate the relationship between hyperinsulinemia and hypokalemic periodic paralysis and to try to find a new way to cure hypokalemic periodic paralysis. Methods Forty-eight patients with hypokalemic periodic paralysis were investigated, oral glucose tolerance tests （OGTT） were carried out on patients, the plasma glucose, insulin and the serum potassium levels were evaluated. Insulin resistent indices were calculated. All the results were compared with those of normal control. Results Compared with normal control group, the oral glucose tolerance tests revealed hyper-response of insulin in hypokalemic periodic paralysism group, also, hyperinsulinemia was found. Insulin resistent indices and insulin levels were higher in patients with hypokalemic periodic paralysis than those in normal control （P〈0.05）. Conclusions The patients with hypokalemlc periodic paralysis could have hyperinsulinemia. Hyperinsulinemia and insulin-induced transmembrane shift of extracellular potassium could be involved in the abnormalities of serum electrolytes and development of hypokalemic periodic paralysis. Prevention and treatment of hyperinsulinemia may become a new way of curing hypokalemic periodic paralysis.