不同年龄新诊断2型糖尿病临床情况比较  

Comparison of clinical conditions of newly-diagnosed type 2 diabetes mellitus patients at different ages

作　　者：林珊珊[1] 郭丽敏[1] 佘其美[1] 杨雪梅[1] 田应芳[1] 

机构地区：[1]首都医科大学石景山教学医院北京市石景山医院内分泌科,北京100043

出　　处：《中国现代医生》2015年第33期9-12,共4页China Modern Doctor

摘　　要：目的探讨新发糖尿病患者血脂、血压、肝肾功能、胰岛功能及胰岛素抵抗等临床情况随增龄的变化。方法2011年1月-2014年12月期间在我院住院且临床资料完全的新发2型糖尿病病例174例,分为年轻组（≤40岁）40例、中年组（年龄41-59岁）77例、老年组（≥60岁）57例。按照1999年WHO诊断标准确诊的新发2型糖尿病患者。比较三组患者的血脂、血压、肝肾功能、胰岛功能及胰岛素抵抗等差异及是否有年龄特征。结果随着年龄的增加,新发糖尿病患者的体重指数、甘油三酯、总胆固醇水平渐下降,但高密度脂蛋白水平渐增加,各组差异均有统计学意义。而低密度脂蛋白水平从年轻组中即已开始升高,但未随增龄逐渐增加。老年组血清肌酐含量与中年组相比较高,差异有统计学意义,但e GFR则在年轻人组开始,显示出随增龄而下降的差异;虽然三组的胰岛素抵抗指数、胰岛功能无差异,但结合e GFR随增龄的改变,需考虑胰岛素抵抗指数、胰岛功能随增龄下降的可能。结论不同年龄段新发糖尿病患者有不同的临床特点。年龄对不同的血脂组分、体重、e GFR、甚至胰岛素抵抗指数、胰岛功能均有影响。Objective To discuss the changes of clinical conditions including blood lipid, blood pressure, hepatic and renal function, pancreas islet function, and insulin resistance of newly-diagnosed type 2 diabetes mellitus patients with age increasing. Methods 174 cases of newly-diagnosed type 2 diabetes mellitus patients diagnosed by WHO 1999 diagnostic criteria and hospitalized in our hospital from January 2011 to December 2014 with complete clinical data were selected and divided into three groups： the group（≤40y） 40 cases, the middle-aged group（41 -59y） 77 cases, and the old group（≥60y） 57 cases. The clinical conditions including blood lipid, blood pressure, hepatic and renal function, pancreas islet function, and insulin resistance were compared across the three groups and whether the changes of these clinical conditions had age characteristics was observed. Results With the increase of age, the BMI, triglyceride, and total cholesterol of newly-diagnosed diabetes mellitus patients gradually reduced, the high-density lipoprotein gradually increased and the differences were statistically significant. Low density lipoprotein began to increase in the young group but didn＇t increase along with age. The serum creatinine in the old group was higher than that in the middle-aged group and the difference was statistically significant. EGFR declined with age increase since the young group. The insulin resistance index and pancreas islet function had no difference across three groups, but combined with the changes of e GFR, it was possible that the insulin resistance index and pancreas islet function decreased with age. Conclusion The clinical conditions of newly-diagnosed diabetes mellitus patients are various. Ages can influence the blood lipid, BMI, e GFR, insulin resistance index and pancreas islet function of patients.

关 键 词：新发2型糖尿病 增龄 血脂 EGFR 胰岛素抵抗指数 胰岛功能 

分 类 号：R587.1[医药卫生—内分泌]