The Relationship Between Glucose Metabolism And The Severity Of Guillain-Barré Syndrome

Background and objective:In recent years,a large number of studies have found that underlying diabetes mellitus(DM)can affect the clinical and electrophysiological pattern of coexisting peripheral neuropathies of other etiologies.GBS is an autoimmune disease characterized by demyelination of peripheral nerves and nerve roots and infiltration of inflammatory cells.The influence of glucose metabolism on the progression and prognosis of GBS has not been established,but the relationship between them is increasingly concerned by clinicians.At present,there is still no large sample of studies on the correlation between glucose metabolism and GBS disease severity and short-term prognosis.The purpose of this study is to explore the relationship between glucose metabolism and the severity and short-term prognosis of GBS,and to provide reference for the diagnosis,treatment and prognosis of GBS patients with glucose metabolism disorders.Methods:We retrospectively studied 290 patients diagnosed as GBS by the department of neurology at the First Hospital of Jilin University from July 2012 to June 2017.According to the classification and diagnostic criteria of glucose metabolism disorders proposed by WHO(2006),we divided patients into normal glucose metabolism group,impaired glucose regulation group and diabetes group.There were 179 cases of normal glucose metabolism(61.7%),30 cases of impaired glucose regulation(10.4%),and 81 cases of diabetes mellitus(27.9%).We compared the clinical features of the three groups of patients.Results:1?There were no significant differences in gender,pre-existing infection,first symptoms,onset to admission time,and cranial nerve involvement in the three groups.2?Compared with the normal glucose metabolism group,the age of impaired glucose regulation group and diabetes group were older,and the difference was statistically significant(P<0.001).3?Compared with the normal glucose metabolism group and the impaired glucose regulation group,the body mass index of diabetic group was larger,and the difference was statistically significant(P<0.001).4?There were differences in the onset seasons among the three groups.Patients in the normal glucose metabolism group had the most incidence in autumn,in the impaired glucose regulation group had the most incidence in spring,and in the diabetes group had the most incidence in winter.5?Disease peak time of diabetes group was shorter than that of normal glucose metabolism group,and the difference was statistically significant(P=0.005),indicating that diabetes can accelerate the progression of GBS patients.6?Compared with the normal glucose metabolism group,diabetes group were more susceptible to sensory abnormalities and autonomic nerve involvement,the differences were statistically significant(P=0.02,P = 0.002).7?Compared with the normal glucose metabolism group,the impaired glucose regulation group and diabetes group were more likely to suffer from dyspnea and ventilator-assisted ventilation,the differences were statistically significant(P<0.001).8?Patients with glucose metabolism disorders were worse than those with normal glucose metabolism.Even if they were hospitalized for a longer period of time,their short-term prognosis was still worse than those with normal glucose metabolism.9?The fasting blood glucose levels in patients with diabetes was related to the severity and short-term prognosis of GBS.The higher their fasting blood glucose levels,the more severe their illness and worse short-term prognosis was.However,there was no correlation between Hb A1 c levels and disease severity and short-term prognosis.Conclusion:Our results suggested that GBS patients with glucose metabolism disorders were more severe and had a worse short-term prognosis.In GBS patients with diabetes,the disease progresses was more rapidly and they were more susceptible to paresthesia and autonomic involvement.Fasting blood glucose levels was related to the severity and short-term prognosis of GBS.And the higher their fasting blood glucose levels,the more severe their illness and worse short-term prognosis was.