住院初诊早发2型糖尿病患者临床特点及危险因素分析  

Clinical Characteristics and Risk Factors in Patients with Newly Diagnosed Early-onset Type 2 Diabetes Mellitus

作　　者：周忠冉 王川[1] ZHOU Zhongran;WANG Chuan(Department of Endocrine and Metabolic Diseases,Qilu Hospital of Shandong University,Jinan 250012,Shandong,China;Department of Endocrinology,Tengzhou Central People's Hospital,Tengzhou 277500,Shandong,China)

机构地区：[1]山东大学齐鲁医院内分泌与代谢病科,山东济南250012 [2]滕州市中心人民医院内分泌科,山东滕州277500

出　　处：《糖尿病新世界》2024年第18期14-17,21,共5页Diabetes New World

摘　　要：目的比较早发和非早发初诊2型糖尿病(type 2 diabetes mellitus,T2DM)患者的临床特点,分析早发T2DM患者发病的危险因素。方法回顾性选取2013年1月—2023年11月山东大学齐鲁医院内分泌与代谢病科住院治疗的790例初诊T2DM患者的临床资料。以40岁为界分为早发组及非早发组,行单因素及多因素Logistic回归分析,明确T2DM早发的危险因素。结果两组患者性别、是否有糖尿病家族史、舒张压、体重指数(body mass index,BMI)、空腹C肽(fasting C-peptide,FCP)、胰岛素抵抗指数(homeostasis model assessment of insulin resistance index,HOMA-IR)、糖化血红蛋白(glycated hemoglobin A1c,HbA1c)、甘油三酯(triglycerides,TG)、尿酸(uric acid,UA)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)比较,差异有统计学意义(P均<0.05)。男性、有糖尿病家族史、BMI≥28 kg/m^(2)、HOMA-IR≥2.5、UA≥420μmol/L是初诊早发T2DM患者发病的独立危险因素(P均<0.05);HDL-C≥1 mmol/L是初诊早发T2DM患者发病的独立保护因素(P<0.05)。结论早发组T2DM患者在发病时即有明显的代谢紊乱、胰岛素抵抗,同时具有更明显的遗传特征。男性、糖尿病家族史、BMI、UA、HDL-C为初诊早发T2DM患者发病的影响因素。Objective To compare the clinical characteristics of early-onset and non-early-onset newly diagnosed type 2 diabetes mellitus(T2DM)patients,analyze the risk factors of early-onset T2DM patients.Methods The clinical data of 790 newly diagnosed T2DM patients who were hospitalized in the Department of Endocrinology and Metabolic Diseases of Qilu Hospital of Shandong University from January 2013 to November 2023 were retrospectively selected.The patients were divided into early-onset group and non-early-onset group by 40 years old.Univariate and multivariate Logistic regression analysis were performed to identify the risk factors of early-onset T2DM.Results There were statistically significant differences in gender,family history of diabetes,diastolic blood pressure,body mass index(BMI),fasting C-peptide(FCP),homeostasis model assessment of insulin resistance index(HOMA-IR),glycated hemoglobin A1c(HbA1c),triglycerides(TG),uric acid(UA)and high density lipoprotein-cholesterol(HDL-C)between the two groups(all P<0.05).Male,family history of diabetes,BMI≥28 kg/m^(2),HOMA-IR≥2.5,UA≥420μmol/L were independent risk factors for the onset of newly diagnosed early-onset T2DM patients(all P<0.05).HDL-C≥1 mmol/L was an independent protective factor for the onset of newly diagnosed early-onset T2DM patients(P<0.05).Conclusion Early-onset T2DM patients have obvious metabolic disorders and insulin resistance at the time of onset,and have more obvious genetic characteristics.Male,family history of diabetes,BMI,UA,HDL-C were the influencing factors of early onset T2DM patients.

关 键 词：早发 初诊2型糖尿病 临床特点 危险因素 

分 类 号：R587.1[医药卫生—内分泌]