Tanaka K, Moriya T, Kanamori A, Yajima Y
Department of Internal Medicine, Kitasato, University School of Medicine, Sagamihara, Kanagawa, Japan.
Diabetes Res Clin Pract. 1999 May;44(2):137-46. doi: 10.1016/s0168-8227(99)00023-6.
It has been reported that excessive intake of sugar-containing soft drinks results in diabetic ketoacidosis (DKA) or ketosis (DK) in obese patients with non-insulin dependent diabetes mellitus (NIDDM). We describe the clinical characteristics and results of long-term follow-up for 24 newly-diagnosed patients with acute-onset NIDDM presenting with DKA or DK. A history of excessive intake of sugar-containing soft drinks was found in 19 (Group A); serious non-diabetic illnesses were found in 5 (Group B). The range of patient ages in Group A was 16 to 57 years while all patients in Group B were 60 years or older. In Group A, no patient was positive for autoantibodies, specific HLAs for Japanese insulin dependent diabetes mellitus, or mutation of the beta-3-adrenergic receptor gene. The body mass indices (BMIs) at onset and admission and serum C-peptide immunoreactivities at admission and discharge were significantly higher in patients in Group A than in patients Group B. In conclusion, we reconfirmed that excessive intake of sugar-containing soft drinks is one of the contributing factors in DKA or DK-onset NIDDM patients. We found no autoimmune mechanism involved in the pathogenesis and that a polymorphism in the beta-3-adrenergic receptor gene could be associated with the development of soft-drink ketosis.
据报道，摄入过量含糖软饮料会导致非胰岛素依赖型糖尿病（NIDDM）肥胖患者发生糖尿病酮症酸中毒（DKA）或酮症（DK）。我们描述了24例以DKA或DK急性起病的新诊断NIDDM患者的临床特征及长期随访结果。19例患者（A组）有摄入过量含糖软饮料史；5例患者（B组）有严重非糖尿病性疾病。A组患者年龄范围为16至57岁，而B组所有患者均为60岁及以上。A组中，无患者自身抗体、日本胰岛素依赖型糖尿病特异性HLA或β-3肾上腺素能受体基因突变呈阳性。A组患者起病时及入院时的体重指数（BMI）以及入院时和出院时的血清C肽免疫反应性均显著高于B组患者。总之，我们再次证实，摄入过量含糖软饮料是DKA或DK起病的NIDDM患者的致病因素之一。我们发现发病机制中无自身免疫机制参与，且β-3肾上腺素能受体基因多态性可能与软饮料性酮症的发生有关。
