发病年龄与初诊2型糖尿病患者酮症的关系  

Study on the relationship between onset age and ketosis in newly diagnosed type 2 diabetes patients

作　　者：闵瑞 徐焱成[1] MIN Rui;XYU Yancheng(Department of Endocrinology,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院内分泌科,武汉430071

出　　处：《公共卫生与预防医学》2021年第2期59-63,共5页Journal of Public Health and Preventive Medicine

摘　　要：目的探讨发病年龄与初诊2型糖尿病(T2DM)患者酮症之间的关系,根据年龄特点为临床上对酮症的早期干预治疗提供参考价值。方法选取研究2016年1月至2019年12月于武汉大学中南医院内分泌科住院的初诊T2DM患者,一项单中心横断面研究。按发病年龄分为青年组、中年组和老年组,分析比较一般临床资料,采用Spearman相关性分析和多因素logistic回归分析年龄与酮症发生的关联。结果青年组患者酮症、男性、超重/肥胖、MS所占比例、TyG、BMI、β-HB、TG水平明显高于中年组和老年组,HbA1c、HOMA-IR、MBS、OGTT0h明显高于老年组,HDL-C明显低于中年组和老年组,AUG胰岛素、IRT2h明显低于老年组(P<0.05)。Spearman相关性分析显示,年龄和HDL-C、AUG胰岛素呈正相关,与BMI、TG、HbA1c、β-HB、HOMA-IR、TyG呈负相关(P<0.05)。多因素logistic回归分析显示,与老年组相比较,中年组、青年组发生酮症的OR分别为2.584、3.870(P<0.05)。结论发病年龄早可增加初诊T2DM患者酮症的发生风险,临床上需加强对青年起病患者的早期综合干预治疗。Objective To explore the relationship between the age of onset and ketosis in patients with newly diagnosed type 2 diabetes mellitus(T2DM),and to provide reference for clinical early intervention and treatment of ketosis according to the characteristics of age.Methods A single center cross-sectional study was conducted to study newly diagnosed T2DM patients who were hospitalized in the Endocrinology Department of Zhongnan Hospital of Wuhan University from January 2016 to December 2019.According to the age of onset,they were divided into young group,middle-aged group and old group.The general clinical data were analyzed and compared.Spearman correlation analysis and multivariate logistic regression were used to analyze the correlation between age and ketosis.Results The proportion of ketosis,males,overweight/obesity,MS,TyG,BMI,β-HB,and TG levels in the young group were significantly higher than those in the middle-aged and old groups,and HbA1c,HOMA-IR,MBS,and OGTT0h were significantly higher than those in the old group.HDL-C in the young group was significantly lower than that in the middle-aged group and old group,and AUG insulin and IRT2h were significantly lower than those in the old group(P<0.05).Spearman correlation analysis showed that age was positively correlated with HDL-C and AUG insulin,and negatively correlated with BMI,TG,HbA1c,β-HB,HOMA-IR,and TyG(P<0.05).Multivariate logistic regression analysis showed that compared with the old group,the OR values of ketosis in the middle-aged group and the young group were 2.584 and 3.870,respectively(P<0.05).Conclusion Early onset age can increase the risk of ketosis in newly diagnosed T2DM patients,and it is necessary to strengthen early intervention and comprehensive treatment for young patients with disease onset.

关 键 词：年龄 2型糖尿病 酮症 糖毒性 脂毒性 胰岛素抵抗 

分 类 号：R181[医药卫生—流行病学]