糖尿病的连续疾病谱学说  

A concept:the continuous spectrum of diabetes mellitus

作　　者：童越 肖扬[1] 罗说明[1] 周智广[1] TONG Yue;XIAO Yang;LUO Shuo-ming;ZHOU Zhi-guang(Department of Metabolism and Endocrinology,the Second Xiangya Hospital,Central South University,Changsha 410011,China)

机构地区：[1]中南大学湘雅二医院代谢内分泌科中南大学糖尿病免疫学教育部重点实验室国家代谢性疾病临床医学研究中心

出　　处：《中国实用内科杂志》2020年第1期1-4,共4页Chinese Journal of Practical Internal Medicine

基　　金：国家自然科学基金（81670772,81870577,81461168031）;国家重点研发计划项目（2016YFC1305000,2016YFC1305001）;湖南省科技重大专项（2017SK1020）

摘　　要：糖尿病连续疾病谱学说认为,从1型糖尿病、高滴度成人隐匿性自身免疫糖尿病(LADA)、低滴度LADA到2型糖尿病,糖尿病表现为连续的疾病谱,中间存在多个过渡类型。该学说最早于2003年提出,随后经典遗传背景、胰岛功能及衰退速度、胰岛自身免疫反应、其他自身免疫病、其他代谢特征、炎症细胞及因子等研究均证实这一学说。该学说有助于深入理解糖尿病异质性的病因学机制,强调多维度、多指标指导临床分型与诊疗,进而推动精准分型的发展。The concept of continuous spectrum of diabetes,first proposed in 2003,claims diabetes,consecutively from type 1 diabetes,latent autoimmune diabetes in adults(LADA)with high glutamic acid decarboxylase antibodies(GADA)titer,LADA with low GADA titer,to type 2 diabetes,represents a continuous spectrum. Ensuing scientific attempts have been corroborating this theory for long,and have been identifying certain evidences in supporting this concept from certain aspects,including classic genetic backgrounds,beta cell function and dysfunction,islet autoimmunity,other autoimmune diseases,metabolic profiles and inflammatory levels. As a result,this concept provides a better understanding of the etiological mechanism for intrinsic heterogeneity of diabetes,a proper approach for a refined multi-dimensional classification and a prosperous future for precision medicine.

关 键 词：糖尿病 连续疾病谱 成人隐匿性自身免疫糖尿病 精准分型 

分 类 号：R587.1[医药卫生—内分泌]