Relationship between fasting plasma glucose level and short-term prognosis of Guillain-Barré syndrome

ObjectiveTo investigate the correlation between abnormal fasting plasma glucose(FPG) level and Guillain-Barré syndrome(GBS), and to analyze whether elevated FPG level being an independent risk factor for poor short-term prognosis in patients with GBS.

MethodsThe clinical data of 146 patients with GBS were retrospectively analyzed.According to the FPG level, the patients were divided into normal FPG group(n=90) and high FPG group(n=56).Gender, age, neurological signs, history of precursor infection, cranial nerve palsy, sensory disturbance, autonomic nerve involvement, difficulty breathing, total score of MRC and Hughes functional grading scale(HFGS) score were compared between the two groups.The differences of protein level, glucose level, protein-cell separation, Pandy test results in cerebrospinal fluid and electrophysiological data between the two groups were analyzed.According to the HFGS score at discharge, the patients were divided into mild group(HFGS score ≤ 3 points) and severe group(HFGS score>3 points).The relationship between FPG level and short-term prognosis of GBS was analyzed.

ResultsThere were no significant differences in age, sex, history of precursor infection, sensory disturbance, decrease or absence of tendon reflex, meningeal irritation sign, neuroelectrophysiological classification and protein level, protein-cell separation, Pandy test results in cerebrospinal fluid between the two groups(P>0.05).The incidence of surgical trauma history, cranial nerve involvement, combination of autonomic nerve dysfunction, difficulty breathing, assisted-ventilation, Babinski sign, HFGS score of 5 and 6 at discharge, and glucose concentration in cerebrospinal fluid in normal FPG group were higher than those in high FPG group(P < 0.05 to P < 0.01), and MRC score at nadir was significantly lower than that in high FPG group(P < 0.01).Univariate analysis showed that age, cranial nerve involvement, autonomic nerve dysfunction, and high protein content, high FPG level, high serum C reactive protein level in cerebrospinal fluid were risk factors of poor short-term prognosis in GBS patients(P < 0.05 to P < 0.01);the cell number in cerebrospinal fluid was not significantly correlated with short-term prognosis in GBS patients(P>0.05).Multivariate logistic regression analysis showed that high age, cranial nerve involvement, and high protein level, high FPG level in cerebrospinal fluid were independent risk factors for poor short-term prognosis in GBS patients(P < 0.05 to P < 0.01).

ConclusionsGBS patients with elevated FPG level are more severe, more likely to have cranial nerve involvement, autonomic nerve dysfunction, difficulty breathing, dependence on mechanical ventilation, and worse short-term prognosis.Elevated FPG level is an independent risk factor for poor short-term prognosis in patients with GBS.