摘要
目的探讨超重与非超重成人隐匿性自身免疫性糖尿病(LADA)的临床特征。方法选取2019年1月至2020年12月在汕头市中心医院内分泌代谢科就诊的LADA患者46例作为研究对象。根据体质量指数(BMI)是否超重分为两组:超重组(n=22)以及非超重组(n=24)。收集患者临床资料,从两组的糖尿病病程、吸烟史、高血压病史、非酒精性脂肪肝(NAFLD)病史、血糖、C肽、抗谷氨酸脱羧酶抗体(GADA)、血脂及慢性并发症发生率等方面对其临床特征进行分析。结果两组年龄、性别、吸烟史、病程、高血压病史、NAFLD病史、糖化血红蛋白、空腹血糖、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇比较,差异无统计学意义(P>0.05),超重组患者甘油三酯水平明显高于非超重组,GADA滴度明显低于非超重组,差异有统计学意义(P<0.05);超重组空腹C肽高于非超重组,差异有统计学意义(P<0.01);超重组大血管并发症发生率高于非超重组,差异有统计学意义(P<0.05);两组微血管并发症、周围神经病变发生率比较,差异无统计学意义(P>0.05)。结论非超重的LADA患者GADA滴度较高,C肽较低,应尽早予胰岛素治疗,超重的LADA患者甘油三酯、大血管并发症发生率更高,应参照2型糖尿病管理模式综合管理减少并发症。
Objective To investigate the clinical features of latent autoimmune diabetes in adults(LADA)in overweight and non-overweight patients.Methods From January 2019 to December 2020,46 LADA patients were selected from the department of endocrinology in Shantou Central Hospital.According to body mass index(BMI),they were divided into two groups:overweight group(n=22)and non-overweight group(n=24).The clinical data of the two groups were collected and analyzed from the course of diabetes,smoking history,hypertension history,nonalcoholic fatty liver disease(NAFLD)history,blood glucose,C-peptide,glutamic decarboxylase autoantibody(GADA),blood lipid and the incidence of chronic complications.Results There was no significant difference in age,gender,smoking history,course of disease,history of hypertension,history of NAFLD,HbA1 c,fasting blood glucose,total cholesterol,high-density lipoprotein and low-density lipoprotein between the two groups(P>0.05).The triglyceride level of patients in the overweight group was significantly higher than that in non-overweight group(P<0.05),and the GADA titer was significantly lower than that in non-overweight group(P<0.05).With regard to the incidence of complications,the incidence of macrovascular complications in the overweight group was higher than that in the non-overweight group(P<0.05),and there was no significant difference in the incidence of microvascular complications and peripheral neuropathy between the two groups(P>0.05).Conclusion Insulin therapy should be given as early as possible in non-overweight LADA patients.Overweight LADA patients should carried out the management according to that of type 2 diabetes to reduce complications.
作者
肖梓栋
XIAO Zi-dong(Endocrinology Department,Shantou Central Hospital,Sun Yat-sen University Affiliated Shantou Hospital,Shantou,Guangdong 515031,China)
出处
《慢性病学杂志》
2021年第7期1009-1011,1015,共4页
Chronic Pathematology Journal
关键词
超重
成人隐匿性自身免疫性糖尿病
临床特征
Overweight
Latent autoimmune diabetes in adults
Clinical characteristics
