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论文摘要

四川大学华西医院住院初诊早发糖尿病患者的回顾性分析

Characteristics of Newly Diagnosed Diabetes Patients with Young Onset in the West China Hospital of Sichuan University

作者:龚媛, 车婷婷, 刘宋芳等

Author:GONG Yuan, CHE Ting-ting, LIU Song-fang.et al

收稿日期:          年卷(期)页码:2014,45(3):524-528

期刊名称:四川大学学报(医学版)

Journal Name:JOURNAL OF SICHUAN UNIVERSITY (MEDICAL SCIENCE EDITION)

关键字:早发糖尿病 代谢综合征 胰岛素抵抗 β细胞功能障碍

Key words:Early onset diabetes mellitus Metabolic syndrome Insulin resistance Insulin secretion dysfunction

基金项目:

中文摘要

目的 研究早发糖尿病人群的临床特征、代谢状况、胰岛素抵抗以及胰岛β-细胞功能,探讨糖尿病早发的原因。 方法 回顾性分折638例华西医院住院糖尿病患者中新诊断及病程≤1年,且谷氨酸脱羧酶抗体、胰岛细胞抗体、胰岛素抗体均为阴性者的临床资料,根据诊断时的年龄分为2组。早发糖尿病组 (诊断年龄15~45岁)342例,晚发糖尿病组 (诊断年龄>45岁)296例。收集所有对象住院病历资料,并用胰岛素抵抗指数 (HOMA2-IR)评估胰岛素抵抗,胰岛素敏感指数 (HOMA2-%S)评估胰岛素敏感性,胰岛细胞功能指数 (HOMA2-%β)评估胰岛细胞分泌功能,餐后30 min胰岛素和空腹胰岛素差值 (ΔI30)与餐后30 min血糖和空腹血糖差值 (ΔG30)的比值 (ΔI30/ΔG30)评估早期胰岛素分泌。比较两组的临床特征、代谢状况、胰岛素抵抗以及胰岛β-细胞功能。 结果 早发糖尿病组患者以酮症、酮症酸中毒起病的比例、糖尿病家族史阳性率、需要使用胰岛素治疗的比例、空腹及餐后2 h血糖、糖化血红蛋白 (HbAlc)、甘油三酯 (TG)均高于晚发糖尿病组 (P均<0.01)。早发糖尿病组患者收缩压、舒张压、体质指数 (BMI)、腰臀比、尿酸 (UA)、空腹及餐后胰岛素和C肽水平低于晚发糖尿病组 (P均<0.01)。早发糖尿病组患者高血压、中心性肥胖、高尿酸、代谢综合征的发生率以及合并3种以上代谢异常的比例低于晚发组 (PPP

英文摘要

Objective To investigate the clinical characteristics, metabolic status, insulin resistance and insulin secretory function of diabetic patients with early onset. Methods The study was undertaken in the West China Hospital of Sichuan University. Characteristics of 342 admitted diabetic patients with early onset (EOD group, diagnosed at age 15-45 years old) were reviewed and compared with 296 admitted patients with late onset (LOD group, diagnosed at age>45 years old). All of the participants had negative islet autoantibodies. Homeostasis model assessment 2 of insulin resistant (HOMA2-IR) and HOMA2 of insulin sencitivity (HOMA2-%S) were measured to estimate insulin resistance and insulin sensitivity. HOMA2 of β-cell function (HOMA2-%β) index was used to estimate β-cell secretory function. We also compared clinical characteristics and metabolic status between the two groups. Results EOD patients were more likely to have ketosis,ketoacidosis, insulin therapy and positive diabetic family history than LOD patients (PPPP

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