| 酮症起病抗体阴性的中青年糖尿病患者的临床特征及分型 |
| 投稿时间：2014-06-24 修订日期：2014-08-19 点此下载全文 |
| 引用本文：黄华英,楼雪勇,任跃忠.酮症起病抗体阴性的中青年糖尿病患者的临床特征及分型[J].医学研究杂志,2015,44(2):140-143 |
| DOI：
10.3969/j.issn.1673-548X.2015.02.039 |
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| 中文摘要:目的 探讨酮症起病抗体阴性的中青年糖尿病患者的临床特征及分型。方法 酮症起病抗体阴性中青年糖尿病患者62例作为研究对象, 将其根据体重指数(BMI)分为肥胖组与非肥胖组, 根据胰岛β细胞功能保留与否分为β+组与β-组, 比较不同组别在年龄、BMI、糖化血红蛋白(HbA1c)、空腹C肽(FCP)、血脂、糖尿病家族史、高血压史等方面的差异, 并对其随访观察, 6个月后比较各组血糖、胰岛功能等情况。并选取非酮症起病2型糖尿病50例作为对照组。结果 酮症起病抗体阴性中青年糖尿病患者起病时平均HbA1c 达12.39%, 男性与女性之比为1.82:1, 超重和肥胖占67.7%, 高甘油三酯血症(TG)占58%;与对照组相比, 患者起病年龄较小, HbA1c较高, FCP较差(P<0.05), BMI、血脂各项、高血压史、6个月后HbA1c和FCP及临床缓解、非胰岛素依赖情况差异无统计学意义。抗体阴性中肥胖组较之非肥胖组, 起病时BMI、TG、糖尿病家族史、高血压史较高, 6个月后胰岛功能恢复明显好于后者, 血糖控制效果更好, 临床缓解和停用胰岛素比例高(P<0.05)。抗体阴性中β+组较之β-组, 起病时BMI、FCP较高, 6个月后胰岛功能恢复明显好于后者, 血糖控制效果更好, 临床缓解和停用胰岛素比例明显高(P<0.05)。结论 酮症起病抗体阴性的中青年糖尿病患者具有许多2型糖尿病类似的临床特点, 大多数经短期胰岛素治疗后胰岛功能恢复较好, 分类上考虑归为酮症倾向的2型糖尿病, 尤其肥胖者和胰岛β细胞功能保留者。 |
| 中文关键词:糖尿病 酮症 肥胖 中青年 抗体阴性 |
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| Clinical Characteristics and Classification of Young and Middle-aged Patients with Ketosis-prone Antibody Negative Diabetes |
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| Abstract:Objective To investigate the clinical characteristics and classification in the young and middle-aged patients with ketosis-prone and negative autoantibody related to diabetes. Methods The research group included 62 subjects and the control group 50 subjects. The research group was divided into positive and negative autoantibody groups, then negative autoantibody group was divided into obesity and non-obesity groups according to body mass index (BMI), and β+and β-groups according to β cells function. Differences were explored between the given groups about age, family history, hypertension history, BMI, glycosylated hemoglobin A1c (HbA1c), fasting C peptide, blood lipids and so on. The blood sugar level and islet function were compared after six months following-up. Results In ketosis autoantibody negative groups, HbA1c was 13.39% on average, male/female was 1.82:1, 67.7% overweight or obese, 58% high blood triglycerides (TG); Compared with the control group, the subjects characterized by smaller age, higher HbA1c, lower FCP(P<0.05), but BMI, blood lipids, hypertension history, HbA1c and FCP after 6 months and clinical remission and discontinued insulin had no significant difference. In obese and non-obese groups of autoantibody negative subjects, there were significant differences BMI, blood press and family history; after six months, the islet function in obesity group was significantly better than that in non-obesity group, the better blood glucose control, higher clinical remission and discontinued insulin. In β+and β- group, there were significant differences in BMI, triglyceride levels, FCP; after six months islet function in group β+was significantly better than group β-, the better blood glucose control, higher clinical remission and discontinued insulin. Conclusion The clinical features with ketosis-prone autoantibody-negative diabetes had similar to type 2 diabetes included recoverable Islet function after short-term insulin treatment, being converted by oral medication. According above, most of diabetes with obesity and recoverable B cells function can be classified as type 2 diabetes. |
| keywords:Diabetes mellitus Ketosis-prone Obesity Young and middle-aged Antibody negative |
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