Fasting Glucose Levels Correlate with Disease Severity of Guillain-Barré Syndrome

Abstract

ObjectiveA potential association between diabetes and Guillain-Barré syndrome (GBS) has been indicated by a few case studies. We retrospectively analyzed the clinical features of a large cohort of GBS patients to explore the relationship between the level of fasting plasma glucose (FPG) obtained in the acute phase at admission and the severity of GBS.MethodsThree hundred and four GBS patients were divided into two groups, one with normal FPG and the other with high FPG levels according to the international standards of FPG.ResultsThe GBS disability scale score was positively, the Medical Research Council (MRC) sum score was negatively correlated to the level of FPG, but not to blood HBA1c or CSF glucose concentrations. A relatively higher FPG level was observed in older and younger GBS patients, and more often in those with cranial nerve involvement, autonomic deficit, dyspnea and ventilator dependence than in patients without these clinical characteristics. Importantly, higher levels of FPG at admission were associated with poorer short-term prognosis measured by the MRC sum score and the GBS disability scale at discharge.ConclusionsOur data demonstrates that FPG in the acute phase of GBS correlates with the severity of GBS and may predict the short-term prognosis of GBS.

Enhanced glycolysis contributes to the pathogenesis of experimental autoimmune neuritis

“…Although the enhanced glycolysis has been reported in systemic lupus erythematosus (SLE) [ 11 ] and autoimmune arthritis [ 12 , 13 ], up to now, no research about the metabolic reprogramming in GBS or EAN can be found. Considering the hypermetabolism and remarkable weight loss in GBS patients [ 14 ] and the fact that fasting glucose levels correlate with the disease severity of GBS [ 15 ], it is plausible to assume that enhanced glycolysis exists and contributes to the pathogenesis of GBS. Thus, we explored the roles of glycolysis in the classic model of EAN with a well-known glycolysis inhibitor, 2-deoxy- d -glucose (2-DG) [ 10 , 16 – 18 ].…”

Integrative metabolomics reveals unique metabolic traits in Guillain-Barré Syndrome and its variants

“…The elevated levels of glucose and the ketone body are a typical clinical symptom in diabetics. Hyperglycemia and ketoacidosis have been reported in blood of GBS patients 26–29 , but it has not been reported that this clinical finding also manifests in the CSF metabolome. On contrary, decreased glucose content was observed in IDDs.…”

Diabetes mellitus may affect short‐term outcome of Guillain‐Barré syndrome

“…In one recent study, diabetes mellitus type 2 was present in 32% of 85 patients with acute polyradiculoneuropathy, and 3‐month prognosis was worse in patients with GBS and diabetes (Bae et al, ) . Higher fasting plasma glucose in the acute phase of GBS correlated with worse motor, autonomic and respiratory deficit and may predict the short‐term prognosis of GBS (Wang et al, ) . There are no other studies about GBS and diabetes mellitus, except for case reports (Wang et al, ) .…”

“…Higher fasting plasma glucose in the acute phase of GBS correlated with worse motor, autonomic and respiratory deficit and may predict the short‐term prognosis of GBS (Wang et al, ) . There are no other studies about GBS and diabetes mellitus, except for case reports (Wang et al, ) . In line with these findings, diabetes mellitus may cause worsening of other neuropathies such as hereditary motor and sensory neuropathy (Sheth et al, ) .…”