Pan C Y, So W Y, Khalid B A K, Mohan V, Thai A C, Zimmet P, Cockram C S, Jorgensen L N, Yeo J P
Chinese PLA General Hospital, Beijing, China.
Diabet Med. 2004 Sep;21(9):1007-13. doi: 10.1111/j.1464-5491.2004.01287.x.
To describe the clinical, biochemical and immunological characteristics of young-onset diabetes in Asia.
Clinical, biochemical and immunological variables were assessed in 919 newly diagnosed (duration less than 12 months) young onset Asian diabetic patients aged between 12 and 40 years. The subjects constituted 57% Chinese, 29% Indians and 14% Malays, recruited from diabetes centres in China, Hong Kong, India, Malaysia and Singapore.
The mean age (+/- sd) was 31.6 +/- 7.2 years, with the majority (66%) in the 31-40 years age group. Mean body mass index (BMI) (+/- sd) was 25.3 +/- 5.0 kg/m2 with 47% exceeding the suggested Asian cut-off point for obesity (BMI > or = 25). Ethnic difference in clinical characteristics included BMI, blood pressure, mode of treatment and degree of insulin resistance. Most patients had a clinical presentation of Type 2 diabetes. About 10% had a classical combination of ketotic presentation, presence of autoimmune-markers and documented insulin deficiency indicative of Type 1 diabetes. Forty-eight percent were receiving oral hypoglycaemic agents (OHAs) while 31% were on diet only, 18% were receiving insulin and 2% were on a combination of insulin and OHA.
Young onset diabetes patients in Asia represent a heterogeneous group in terms of their clinical and biochemical characteristics and classical Type 1 diabetes is relatively uncommon. The 5-year follow up study will determine the progress of these patients and help to clarify the natural history.
描述亚洲青年发病型糖尿病的临床、生化及免疫学特征。
对919例新诊断(病程小于12个月)的12至40岁亚洲青年糖尿病患者的临床、生化及免疫学变量进行评估。这些受试者包括57%的中国人、29%的印度人及14%的马来人,从中国、中国香港、印度、马来西亚及新加坡的糖尿病中心招募而来。
平均年龄(±标准差)为31.6±7.2岁,大多数(66%)在31至40岁年龄组。平均体重指数(BMI)(±标准差)为25.3±5.0kg/m²,47%超过亚洲肥胖建议切点(BMI≥25)。临床特征的种族差异包括BMI、血压、治疗方式及胰岛素抵抗程度。大多数患者表现为2型糖尿病。约10%具有酮症表现、自身免疫标志物及记录的胰岛素缺乏的典型组合,提示1型糖尿病。48%正在接受口服降糖药(OHAs)治疗,31%仅接受饮食治疗,18%接受胰岛素治疗,2%接受胰岛素与OHAs联合治疗。
亚洲青年发病型糖尿病患者在临床和生化特征方面表现为异质性群体,经典1型糖尿病相对少见。5年随访研究将确定这些患者的病情发展并有助于阐明其自然病程。