title: Evaluation of glucose metabolic disorder: insulin resistance and insulin receptors in critically ill children.
abstract: OBJECTIVE
  To explore the pathogenesis of glucose metabolic disorder and insulin resistance in critically ill children under severe stress.
  
  
  METHODS
  To test glucose, lactate, glucagon, insulin, c-peptide, cortisol levels in 50 critically ill children. While we measured 125I-insulin binding to erythrocytes of 13 critically ill children who had hyperglycemia and hyperinsulinemia. Glucose and lactate were measured biochemically. Insulin, c-peptide, cortisol and glucagon were determined by RIA. Erythrocytes insulin receptor was detected by insulin radioreceptor assay.
  
  
  RESULTS
  Glucose, lactate, insulin, c-peptide, glucagon, cortisol, insulin/glucose, insulin/glucagon ratio in patients were higher than those in normal controls (P < 0.05). As compared with normal controls, the maximum 125I-insulin bound and insulin receptor number per cell were significantly lower (P < 0.01). But there was no difference of mean value in receptor affinity (P > 0.05).
  
  
  CONCLUSIONS
  Hyperglycemia is common in critically ill children during stress, which may be attributed to hormones disturbance and tissure insulin resistance. Insulin receptor defect due to comprehensive factors was one of the important causes for insulin resistance. The blood glucose level can be used as an predicting index in ICU.
authors.affiliation: Pediatric Intensive Care Unit, Children's Hospital, Chongqing University of Medical Sciences.
authors.forename: F
authors.initials: F
authors.lastname: Xu
authors.forename: X
authors.initials: X
authors.lastname: Yang
authors.forename: Z
authors.initials: Z
authors.lastname: Lu
authors.forename: F
authors.initials: F
authors.lastname: Kuang
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000378:metabolism*; D006946:Hyperinsulinism / Q000378:metabolism*; D007223:Infant; D007333:Insulin Resistance; D008297:Male; D009102:Multiple Organ Failure / Q000097:blood; D011972:Receptor, Insulin / Q000097:blood*
chemical_list: D001786:Blood Glucose; D011972:Receptor, Insulin