Hillier T A, Pedula K L
Kaiser Permanente Center for Health Research Northwest/Hawaii Division, 3800 N. Interstate Ave., Portland, OR 97227-1098, USA.
Diabetes Care. 2001 Sep;24(9):1522-7. doi: 10.2337/diacare.24.9.1522.
To determine whether adults diagnosed with type 2 diabetes at 18-44 years of age (early type 2 diabetes) have different metabolic profiles at diagnosis than adults diagnosed at > or =45 years of age (usual type 2 diabetes).
Within a health maintenance organization, we studied characteristics among 2,437 adults newly diagnosed with type 2 diabetes between 1996 and 1998 who had measured weight, HbA(1c), blood pressure, and cholesterol within 3 months of diagnosis. We abstracted clinical data from electronic medical records. We compared mean and proportional differences with parametric t tests and chi(2) analyses, respectively. We used multiple logistic regression to identify the factors independently associated with the onset group (early vs. usual type 2 diabetes).
There was an inverse linear relationship between BMI and age at diagnosis of type 2 diabetes (P < 0.001). On univariate analysis, adults with early type 2 diabetes were more obese (BMI 39 vs. 33 kg/m(2), P < 0.001), were more likely to be female (P = 0.04), had slightly worse glycemic control (HbA(1c) 7.7 vs. 7.5%, P = 0.03), had a higher prevalence of diastolic hypertension (37 vs. 26%, P < 0.001), despite a lower prevalence of systolic hypertension (34 vs. 55%, P < 0.001), and had an equally high rate of abnormal lipids (82 vs. 78%, P = 0.13) than adults with usual type 2 diabetes. BMI, female gender, cholesterol, and diastolic and systolic blood pressure remained independently associated with onset group at multivariate analysis.
Although both onset groups were on average obese, the inverse linear relationship of obesity and age of diabetes onset that we observed suggests that obesity is a continuous risk rather than a threshold risk for diabetes onset. Both onset groups had a high prevalence of cardiovascular disease risk factors.
确定18 - 44岁被诊断为2型糖尿病的成年人（早发型2型糖尿病）在诊断时的代谢特征是否与45岁及以上被诊断为2型糖尿病的成年人（普通型2型糖尿病）不同。
在一个健康维护组织中，我们研究了1996年至1998年间新诊断为2型糖尿病的2437名成年人的特征，这些人在诊断后3个月内测量了体重、糖化血红蛋白（HbA1c）、血压和胆固醇。我们从电子病历中提取临床数据。我们分别使用参数t检验和卡方分析比较均值和比例差异。我们使用多元逻辑回归来确定与发病组（早发型与普通型2型糖尿病）独立相关的因素。
2型糖尿病诊断时的体重指数（BMI）与年龄呈负线性关系（P < 0.001）。单因素分析显示，早发型2型糖尿病成年人更肥胖（BMI 39 vs. 33 kg/m²，P < 0.001），更可能为女性（P = 0.04），血糖控制略差（HbA1c 7.7% vs. 7.5%，P = 0.03），舒张期高血压患病率更高（37% vs. 26%，P < 0.001），尽管收缩期高血压患病率较低（34% vs. 55%，P < 0.001），且血脂异常率与普通型2型糖尿病成年人相当（82% vs. 78%，P = 0.13）。多因素分析时，BMI、女性性别、胆固醇以及舒张压和收缩压仍与发病组独立相关。
尽管两个发病组平均而言都肥胖，但我们观察到的肥胖与糖尿病发病年龄的负线性关系表明，肥胖是糖尿病发病的持续风险而非阈值风险。两个发病组心血管疾病危险因素的患病率都很高。
