Fig 1.
Flow chart of subject enrollment.
This study was based on a database comprising 518 consecutive GBS patients. Patients under 18 years of age, diagnosed as Miller Fisher syndrome or CIPD and who received corticosteroid treatment prior to hospitalization were excluded. 350 GBS patients were finally enrolled.
Table 1.
Description of GBS patients in normal FPG glucose group and high FPG glucose group.
Fig 2.
Clinical features of the patients in the high FPG group.
(A) 304 subjects were divided into two groups. 217 patients whose FPG concentration was within the normal range (3.9–6.1 mmol/L) fell into the normal FPG group and the other 87 patients with a FPG concentration more than 6.1 mmol/L were put into the high FPG group. The GBS disability scale scores at nadir from 1 to 6 corresponded to 11.62%, 14.42%, 20.47%, 46.51%, 6.51% and 0.47% in the normal FPG group and to 8.33%, 3.57%, 15.48%, 44.05%, 26.19% and 2.38% of all patients in the high FPG group. The GBS disability scale score in the high FPG group was higher than that in the normal FPG group (p = 0.002). (B) Weakness in extremities was expressed using the MRC sum score of six bilateral muscles in arms and legs, ranging from 0 (teraparalytic) to 60 (normal strength). The MRC sum score for each level from 0–10 to 51–60 corresponded to 5.11%, 6.51%, 11.63%, 15.35%, 31.63% and 29.77% in the normal FPG group, while it was 14.30%, 9.52%, 9.52%, 22.61%, 27.38% and 16.67% in the high FPG group, indicating that the MRC sum score was rather lower in the high FPG group (p = 0.000). (C) The MRC sum score at study entry for each level from 0–10 to 51–60 corresponded to 1.87%, 4.21%, 8.88%, 15.42%, 32.24% and 37.38% in the normal FPG group, while it was 8.24%, 7.06%, 10.59%, 16.47%, 32.94% and 24.71% in the high FPG group. (D) Patients in the high FPG group had a tendentiousness of cranial nerve involvement, autonomic deficits, dyspnea, and ventilator dependence. The percentages of cranial nerve involvement, autonomic deficits, dyspnea and ventilator dependence were 25.12%, 39.63%, 49.77%, 21.20% and 6.45% in the normal FPG group, while it was 37.93%, 52.87%, 71.26%, 40.23% and 26.44% in the high FPG group (p < 0.05). *p < 0.05, **p < 0.01, *** p < 0.001.
Table 2.
Comparative study between high FPG group 1 and high FPG group 2.
Fig 3.
Relationship between the levels of CSF glucose/HbA1c and the severity of GBS.
(A) 191 patients with available laboratory data of glucose in CSF were divided into two groups. Patients with CSF glucose concentration higher than 4.1 mmol/L fell into the high CSF glucose group, and the others into the normal CSF group. A high level of CSF glucose appeared in the patients who demonstrated cranial nerve involvement, hypoesthesia and autonomic deficits (3.90 mmol/L, 3.93 mmol/L and 3.87 mmol/L vs 3.68 mmol/L, 3.68 mmol/L and 3.67 mmol/L) (p < 0.05). (B) Relationships between CSF glucose concentration and the MRC sum score at nadir were measured by the linear regression (R2 = 0.03, p = 0.469). (C) The logistic regression was done to examine the relationship between the CSF glucose concentration and the GBS disability scale score (R2 = 0.003, p = 0.449). (D) The logistic regression was performed to explore the relationship between the HbA1c proportion and the GBS disability scale score (R2 = 0.029, p = 0.377).