成人迟发自身免疫性糖尿病与1、2型糖尿病临床表现的比较  

Comparison of clinic characters among patients with latent autoimmune diabetes in adults and type 1 or type 2 diabetes

作　　者：吴艺捷[1] 赵立[1] 胡远峰[1] 张洪德[1] 董维平[1] 

机构地区：[1]上海市第一人民医院内分泌科,糖尿病研究室,200080

出　　处：《中国糖尿病杂志》2002年第4期212-215,共4页Chinese Journal of Diabetes

摘　　要：目的　探讨成人迟发自身免疫性糖尿病 (L ADA)的临床特征。　方法　评价谷氨酸脱羧酶抗体 (GADA)、胰岛细胞抗体 (ICA)阳性 L ADA患者各种急性和慢性并发症的患病率 ,并与速发型 1和 2型糖尿病 (DM)相比较。　结果　 L ADA患者的年龄、BMI、空腹及餐后 C肽水平介于 1和 2型 DM之间。L ADA组 2 9%患者有酮症 ,再次酮症的频度与 1型相似 ,但至首次酮症的时间较长。视网膜病变患病率为 19.5 % ,与 1型 DM相似 ;白内障患病率为 4 8.8% ,与 2型 DM相似 ;冠心病患病率与 2型 DM相似 ,高血压患病率介于 1、2型 DM之间。L ADA组有微量白蛋白尿者较少 ,3组间显性肾病变、周围神经病变和高脂血症的患病率相似。　结论　 L ADA的临床特征及急性和慢性并发症的患病率与 1和 2型Objective To study the clinic characters of patients with latent autoimmune diabetes in adults (LADA). Methods We evaluated the prevalence of acute and chronic complications in the LADA patients with serum antibodies to glutamic acid decarboxylase (GADA) or to islet cell cytoplasmic antigens (ICA). The prevalence of acute and chronic complications were further compared with that in patients with acute onset type 1 or type 2 diabetes. Results The mean age, BMI, fasting and postprandial C peptide levels of the LADA patients were higher than those of type 1 diabetes and lower than those of type 2 diabetes. Of the LADA patients, 29.3% had ketosis. Although the frequency of repeated attack of ketosis in the LADA patients was similar to that in type 1 diabetes, the duration from diabetic onset to first ketosis in the LADA patients was much longer. The prevalence of retinopathy in the LADA patients was 19.5%, which was similar to that in type 1 diabetes. The prevalence of cataract in the LADA patients was 48.8%, which was similar to that in type 2 diabetes. Less LADA patients had microalbuminuria, compared with the other groups. There was no difference in the prevalence of overt nephropathy, neuropathy and hyperlipidemia among the three groups. The prevalence of coronary heart disease in the LADA patients was similar to that in type 2 diabetes. The prevalence of hypertension in the LADA patients was higher than that in type 1 but lower than that in type 2 diabetes. Conclusion The clinic characters as well as acute and chronic complications in LADA patients are different from those in type 1 and type 2 diabetes.

关 键 词：自身免疫性糖尿病 2型糖尿病 临床表现 糖尿病 并发症 LADA 1型糖尿病 患病率 差异性 

分 类 号：R587.1[医药卫生—内分泌]