Esmatjes Enric, Fernández Cristian, Rueda Sergio, Nicolau Juana, Chiganer Gastón, Ricart María José, Junca Elizabet, Fernández-Cruz Laureano
Department of Endocrinology and Nutrition, Hospital Clinic Universitari, Barcelona, Spain.
Clin Transplant. 2007 May-Jun;21(3):358-62. doi: 10.1111/j.1399-0012.2007.00649.x.
It is not unusual for simultaneous pancreas and kidney transplantation (SPK) to be performed in patients with type 2 diabetes (T2D), clinically classified as having type 1 diabetes (T1D). C-peptide determination is useful to identify these patients. We describe the prevalence and characteristics of patients with C-peptide levels >3 ng/mL, classified with T2D in 172 patients referred for SPK from 1998-2006. Nine patients (5.2%) fulfilled this criteria (mean free C-peptide 9.08 ng/mL) and were older at diabetes onset (23.5 vs. 12 yr, p < 0.001) and at assessment (42.2 vs. 37.6 yr, p = 0.047) with shorter time between diabetes onset and renal failure (17.8 vs. 22.7 yr, p = 0.3) compared with T1D patients (mean free C-peptide 0.24 ng/mL). In our experience the prevalence of T2D in candidates for SPK is not negligible. Despite some clinical differences with T1D these T2D patients can phenotypically be confounded with T1D in the absence of C-peptide determination.
对于2型糖尿病（T2D）患者进行胰肾联合移植（SPK），临床上将其归类为1型糖尿病（T1D）的情况并不罕见。C肽测定有助于识别这些患者。我们描述了1998年至2006年间转诊接受SPK的172例患者中C肽水平>3 ng/mL且归类为T2D患者的患病率和特征。9例患者（5.2%）符合该标准（平均游离C肽9.08 ng/mL），与1型糖尿病（T1D）患者（平均游离C肽0.24 ng/mL）相比，其糖尿病发病年龄（23.5岁对12岁，p<0.001）和评估时年龄（42.2岁对37.6岁，p = 0.047）更大，糖尿病发病至肾衰竭的时间更短（17.8年对22.7年，p = 0.3）。根据我们经验，SPK候选患者中T2D的患病率不可忽略。尽管与T1D存在一些临床差异，但在未进行C肽测定的情况下，这些T2D患者在表型上可能与T1D混淆。
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