中国亚热带地区糖尿病流行与分型研究  

TO STUDY PREVALENCE AND CLASSIFICATION OF DIABETES MELLITUS IN SUBTROPICS OF CHINA

作　　者：于志清[1] 潘海林[1] 黎英荣[1] 何玉玲[1] 邓宏明[1] 洪英[1] 夏宁[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代谢糖尿病防治研究中心,南宁530021

出　　处：《广西医科大学学报》1999年第6期728-731,共4页Journal of Guangxi Medical University

基　　金：广西区科技厅自然科学基金!赞助项目 ( 93 15 2 40

摘　　要：目的:了解中国亚热带地区糖尿病(DM)及糖耐量降低(IGT)14年来的流行状况,探讨非超重2型DM中需胰岛素治疗(ITDM)的病因及分型。方法:1按照WHO诊断标准及全国统一的调查方法,患病率用1990年全国人口结构及1993年世界人口结构进行标化;2利用PLR/SSO方法在IDDM、ITDM及健康对照组作HLADQB1、DQA1的基因分型;3用酶联免疫法ELISA测ICA及GAD-Ab;4用放免法测血浆C肽、胰高血糖素及胰岛素专一受体的浓度和亲和力;5部分患者作了胰腺的B超及CT检查。结果:1DM世界标化率为30.0‰,IGT为43.0%,非超重DM患者占56.1%;2HLADQ基因分型在IDDM组DQA1*0301频率为88.8%,明显高于对照组(P<0.001),DQB1*0201,*0302的频率高于对照组,有显著差异(P<0.01)。ITDM组ICA(+)47.7%DQB1*0201与对照组比无明显差异(P>0.05)。DQB1*0502频率为61.9%,明显高于IDDM组及对照组(P<0.001);3IDDM组ICA阳性率36.4%,GAD-Ab阳性66.6%。ITDM组GAD-Ab54%;ICA47.7%;44例胰腺CT有胰腺萎缩胰管扩张及钙化。结论:11994年DM及IGT患病率比1980年分别增高2.25倍及4.56倍,达到了世界度流行;2首次在国内报道亚热带地区在非超重2型DM中可有4种类型DM存在,ITDM分型有利于合理制定预防及治疗方案。Objective:Studies made on the prevalence of DM and IGT in subtropical areas of China during the past 14 years, and on the resulting causes and Classifications of cases requiring insulin treatment in Type 2 DM of Non Overweight (ITDM) Method:Initial screening was carried out under 1985 WHO criteria and National DM survey scheme in 1994;HLA gene typing was determined in IDDM and ITDM;Radio immunoassay (RIA) was applied to test insulin secretion;ICA and GAD Ab were examined with enzyine linked immunosorbent assay (ELISA) Results:[WT5,5”BZ]A standard rate of prevalence of DM and IGT was found 30 0‰ and 43 0‰ respectively in the areas of China The relationship between HLAQA 1,DQB 1 gene and IDDM and ITDM and healthy control was investigated,and compared with controls,the frequency of HLA DQA 1*0301,and DQB 1*0201,*0302 was significantly higher in IDDM (P<0 01) and that of HLA DQB 1 *0502 had also a higher indication in ITDM patients There might be a suggestion that HLA DQB 1 gene was associated with ITDM The frequency of ICA and GAD Ab in the group was 36 4% and 54%,suggesting an undubious existence of latent auto immune diabetes in Adults (LADA) In some cases pancreane calcification was demonstrated by ultrasonic graphy and CT scan Conclusion:This area's prevalence of DM and IGT has reached moderate world levels,and it is 2 25 time and 4.56 time higher than that of 14 years ago

关 键 词：亚热带地区 糖尿病 分型 非超重2型糖尿病 糖耐量降低 

分 类 号：R587.1[医药卫生—内分泌]