Pei Dee, Hsiao Chin-Fu, Hung Yi-Jen, Hsieh Chang-Hsun, Fang Sandra-Chi, Lian Wei-Chen, Hsu Wen-Lin, Fu Chen-Chung, Chen Hsin-Dean, Kuo Shi-Wen
Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan, ROC.
Diabetes Metab Res Rev. 2006 Jan-Feb;22(1):26-33. doi: 10.1002/dmrr.522.
Insulin sensitivity (SI), glucose sensitivity (SG), acute insulin response to glucose load (AIR), and obesity in adolescent type 2 diabetes patients (young diabetes, YDM) in Taiwan were studied.
Forty patients diagnosed at <22 years of age were enrolled and divided into non-obese (NOYDM, BMI < 27 kg/m(2)) and obese groups (OBYDM BMI > 27 kg/m(2)). Adult-onset type 2 diabetes patients (ADM) >40 years old (n = 41) and nondiabetic young adults (N) (n = 23) served as controls. Fasting plasma lipids, insulin, and glucose were measured. Homeostasis model assessment was calculated to estimate insulin sensitivity and beta-cell function. A frequent-sampled intravenous glucose tolerance test was performed to evaluate SI, SG, and AIR.
SI and AIR were significantly lower in YDM and ADM than in N (0.92 +/- 0.13, 0.8 +/- 0.15 and 3.24 +/- 0.47 x 10(-4)/U/mL for SI; 40.3 +/- 20.3, 107.3 +/- 50.2, 1208 +/- 306.3 uU/min for AIR). SG of YDM and ADM were lower compared with N (0.014 +/- 0.00138, 0.0292 +/- 0.0058 vs 0.034 +/- 0.0086 min(-1) respectively). No difference was noted between YDM and ADM. SI and SG were not different in NOYDM and OBYDM. AIR was higher in OBYDM (83.6 +/- 34.3 vs -7.6 +/- 13.66 uU/min).
YDM had defects in SI, SG, and AIR compared to N, which was similar to the pathophysiology of ADM. The results imply that YDM may be either a different subtype of diabetes or the same type of diabetes as ADM, with severe defects associated with earlier age of onset. OBYDM had higher AIR than NOYDM.
对台湾青少年2型糖尿病患者（青年糖尿病，YDM）的胰岛素敏感性（SI）、葡萄糖敏感性（SG）、对葡萄糖负荷的急性胰岛素反应（AIR）及肥胖情况进行了研究。
纳入40例诊断时年龄小于22岁的患者，并分为非肥胖组（非肥胖青年糖尿病患者，NOYDM，BMI<27kg/m²）和肥胖组（肥胖青年糖尿病患者，OBYDM，BMI>27kg/m²）。40岁以上的成人2型糖尿病患者（ADM）（n=41）和非糖尿病青年成人（N）（n=23）作为对照。测量空腹血脂、胰岛素和葡萄糖。计算稳态模型评估以估计胰岛素敏感性和β细胞功能。进行频繁采样的静脉葡萄糖耐量试验以评估SI、SG和AIR。
YDM和ADM的SI和AIR显著低于N（SI分别为0.92±0.13、0.8±0.15和3.24±0.47×10⁻⁴/U/mL；AIR分别为40.3±20.3、107.3±50.2、1208±306.3uU/min）。YDM和ADM的SG低于N（分别为0.014±0.00138、0.0292±0.0058与0.034±0.0086min⁻¹）。YDM和ADM之间未观察到差异。NOYDM和OBYDM的SI和SG无差异。OBYDM的AIR较高（83.6±34.3与-7.6±13.66uU/min）。
与N相比，YDM在SI、SG和AIR方面存在缺陷，这与ADM的病理生理学相似。结果表明，YDM可能是糖尿病的不同亚型或与ADM相同类型的糖尿病，严重缺陷与发病年龄较早有关。OBYDM的AIR高于NOYDM。
