合并代谢综合征的新诊断酮症起病糖尿病患者临床特征及胰岛素抵抗分析  

Analysis of Clinical Characteristics and Insulin Resistance in Newly Diagnosed Ketosis-onset Diabetes Patients with Metabolic Syndrome

作　　者：闵瑞 徐焱成[1] MIN Rui;XU Yan-cheng(Department of Endocrinology,Zhongnan Hospital of Wuhan University,Wuhan,Hubei 430071,China)

机构地区：[1]武汉大学中南医院内分泌科,湖北武汉430071

出　　处：《湖北医药学院学报》2020年第6期586-590,595,共6页Journal of Hubei University of Medicine

摘　　要：目的:对合并代谢综合征(Metabolic syndrome,MS)的新诊断酮症起病糖尿病(Ketosis-onset diabetes mellitus,KODM)患者的临床特点和胰岛素抵抗程度进行分析,以探讨此类患者的初步分型。方法:选取新诊断KODM患者170名,包括116名合并MS组(KODM+MS组)和54名不合并MS组(KODM-MS组),另外选取同期新诊断2型糖尿病(Type 2 diabetes mellitus,T2DM)患者228名,包括144名合并MS组(T2DM+MS组)和84名不合并MS组(T2DM-MS组)。比较KODM+MS组与其他3组的临床特点和胰岛功能。结果:⑴KODM+MS组年龄、HDL-C明显小于其他3组,TG、FFA、TyG明显大于其他3组,差异均有统计学意义(P<0.05)。⑵KODM+MS组男性患者比例、BMI、TC、UA、超重或肥胖、高血压、血脂异常、非酒精性脂肪肝、颈动脉粥样硬化患病率、FINS、FCP、2hCP、HOMA-IR明显大于KODM-MS组(P<0.05)。⑶KODM+MS组RBG、GSP、FBG、2hPBG、HbA1c、胰岛素用量明显大于T2DM+MS组,FINS、2hINS、FCP、2hCP、HOMA-IR明显小于T2DM+MS组。⑷男性患者比例、糖尿病家族史、BMI、TC、UA、超重或肥胖、高血压、血脂异常、非酒精性脂肪肝、颈动脉粥样硬化患病率KODM+MS组和T2DM+MS组比较差异无统计学意义(P>0.05)。结论:合并代谢综合征(MS)的新诊断酮症起病糖尿病(KODM)患者的临床特点及胰岛素抵抗程度更接近于2型糖尿病。Objective The clinical characteristics and the degree of insulin resistance of newly diagnosed ketosis-onset diabetes mellitus(KODM)patients with metabolic syndrome(MS)were analyzed to explore the preliminary classification of these patients.Methods 170 patients with newly diagnosed KODM were selected,including 116 patients with MS(KODM+MS group)and 54 patients without MS(KODM-MS group).228 patients with newly diagnosed type 2 diabetes mellitus(T2DM)in the same period were also selected,including 144 patients with MS(T2DM+MS group)and 84 patients without MS(T2DM-MS group).The clinical features and islet function of KODM+MS group were compared with those of the other three groups.Results⑴The age and HDL-C of KODM+MS group were significantly lower than those of KODM-MS,T2DM+MS and KODM-MS groups,while TG,FFA and TyG were significantly higher than those of KODM-MS,T2DM+MS and KODM-MS groups(P<0.05).⑵The proportion of male patients,BMI,TC,UA,overweight or obesity,hypertension,dyslipidemia,nonalcoholic fatty liver,carotid atherosclerosis,FINS,FCP,2hCP and HOMA-IR in KODM+MS group were significantly higher than those in KODM-MS group(P<0.05).⑶RBG,GSP,FBG,2hPBG,HbA1c and insulin dosage in KODM+MS group was significantly higher than those in T2DM+MS group,while FINS,2hINS,FCP,2hCP and HOMA-IR in KODM+MS group were significantly lower than those in T2DM+MS group(P<0.05).⑷The proportion of male patients,family history of diabetes,BMI,TC,UA,overweight or obesity,hypertension,dyslipidemia,nonalcoholic fatty liver and carotid atherosclerosis were not significantly different between KODM+MS group and T2DM+MS group(P<0.05).Conclusion The clinical characteristics and insulin resistance of newly diagnosed KODM with MS are closer to T2DM.

关 键 词：酮症起病糖尿病 代谢综合征 2型糖尿病 酮症 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌] R589[医药卫生—内科学]