成人隐匿性自身免疫性糖尿病与2型糖尿病临床特点的比较  

Comparison of clinical characteristics between LADA and type 2 diabetes mellitus

作　　者：何玉玲[1] 于志清[1] 肖常青[1] 李世生[1] 

机构地区：[1]广西医科大学第一附属医院糖尿病代谢研究中心,南宁530021

出　　处：《广西医学》2005年第7期982-983,共2页Guangxi Medical Journal

摘　　要：目的探讨成人隐匿性自身免疫性糖尿病(LADA)的临床特点。方法对20例LADA患者和46例2型糖尿病患者的临床特点及并发症情况进行比较。结果LADA组与2型糖尿病组相比:起病年龄小[(46.6±8.48)岁对(52.74±7.60)岁, P<0.01],体重指数较低[(20.89±2.75)kg/m2 对(23.07 4-2.60)kg/m2,P<0.01],空腹及餐后2h c肽水平低分别为[(0.41±0.20)nmol/L对(0.61±0.30)nmol/L,(0.91±0.42)nmol/L对(1.65 ±0.83)nmol/L,P<0.01],HBA1c较高[(10.95±2.00)%对(9.56±2.30)%,P<0.05],出现自发酮症(6/20对2/46,P<0.01)及使用胰岛素治疗的比例较高(11/20对11/46,P<0.05),合并高血压和高脂血症的比例较低(分别为2/20对16/46、3/20对19/46,P<0.05),微血管并发症的患病率两组间差异无显著性。结论LADA患者具有起病年龄小、体重指数低、C肽水平低、易出现自发酮症,合并高血压和高脂血症的比例较少,微血管并发症的患病率与2型糖尿病相似。Objective To study the clinical characteristics of patients with latent autoimmune diabete mellitus in adults （LADA）. Methods Clinical characteristics and chronic complications between 20 cases of LADA and 46 cases of type 2 diabetes mellitus （T2DM） were compared. Results Compared with T2DM, LADA group showed a younger age at onset[ （46.6 ± 8.84） a vs （52.74 ± 7.60） a, P 〈 0.01 ], lower BMI[ （20.89 ± 2.75）kg/m^2 vs （23.07 ± 2.60） kg/m^2, P 〈 0.01 ] ,lower fasting and postprandial C-peptide[ （0.41 ± 0.20） nmol/L vs （0.61 ± 0.30） nmol, （0.91 ± 0.42）nmol/L vs （1.65 ± 0. 83） nmol/L, P 〈 0.01 ], higher HbA1C （10.95 ± 2.0）% vs （9.56 ± 2.30）%, P 〈 0.05], higher prevalence of spontaneous ketosis （6/20 vs 2/46, P 〈 0.01 ） and insulin therapy （ 11/20 vs 11/46, P 〈 0.05）, less hypertension and hyperlipidemia （2/20 vs 16/46,3/20 vs 19/46, P 〈 0.05） .There was no significant difference in the prevalence of diabetic microvascular comphcaton. Conclusion By comparison with type 2 diabetes mellitus, LADA patients have younger age at onset, lower BMI, lower C-pcptide level, higher prevalence of spontaneous ketosis and insulin therapy, less hypertension and hyperhpidemia. LADA patients present similar diabetic microvascular comphcation to type 2 diabetes.

关 键 词：成人隐匿性自身免疫性糖尿病 2型糖尿病 胰岛细胞抗体 并发症 

分 类 号：R587.1[医药卫生—内分泌]