Sobngwi Eugène, Choukem Siméon Pierre, Agbalika Felix, Blondeau Bertrand, Fetita Lila-Sabrina, Lebbe Céleste, Thiam Doudou, Cattan Pierre, Larghero Jérôme, Foufelle Fabienne, Ferre Pascal, Vexiau Patrick, Calvo Fabien, Gautier Jean-François
Department of Endocrinology and Diabetes, Saint-Louis University Hospital, 1 Avenue Claude Vellefaux, 75475 Paris Cedex 10, France.
JAMA. 2008 Jun 18;299(23):2770-6. doi: 10.1001/jama.299.23.2770.
An atypical form of type 2 diabetes mellitus (DM-2) is revealed by ketosis (ketosis-prone type 2 diabetes mellitus), frequently occurring in individuals who are black and of African origin, and characterized by an acute onset requiring transient insulin therapy. Its sudden onset suggests precipitating factors.
To investigate the putative role of human herpesvirus 8 (HHV-8) in the pathogenesis of ketosis-prone DM-2.
DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional study in which antibodies were searched against latent and lytic HHV-8 antigens using immunofluorescence. The presence of HHV-8 in genomic DNA was investigated in 22 of the participants at clinical onset of diabetes. We also tested whether HHV-8 was able to infect human pancreatic beta cells in culture in vitro. The study was conducted at Saint-Louis University Hospital, Paris, France, from January 2004 to July 2005. All participants were black and of African origin: 187 were consecutive diabetic patients of whom 81 had ketosis-prone DM-2 and 106 had nonketotic DM-2, and 90 individuals were nondiabetic control participants who were matched for age and sex.
Seroprevalence of HHV-8 and percentage of patients with HHV-8 viremia at onset in ketosis-prone DM-2.
HHV-8 antibodies were found in 71 patients (87.7%) with ketosis-prone DM-2 vs 16 patients (15.1%) with nonketotic DM-2 (odds ratio, 39.9; 95% confidence interval, 17.1-93.4; P < .001) and 36 of the control participants (40.0%) (odds ratio, 10.7; 95% confidence interval, 4.9-23.4; P < .001). HHV-8 in genomic DNA was present in 6 of 13 patients with ketosis-prone DM-2 tested at acute onset and in 0 of 9 patients with nonketotic DM-2. HHV-8 proteins were present in human islet cells that were cultured for 4 days in the presence of HHV-8.
In this preliminary cross-sectional study, the presence of HHV-8 antibodies was associated with ketosis-prone DM-2 in patients of sub-Saharan African origin. Longitudinal studies are required to understand the clinical significance of these findings.
一种非典型的2型糖尿病（2型糖尿病酮症倾向型）通过酮症表现出来，常见于黑人及非洲裔个体，其特征为急性起病，需要短期胰岛素治疗。其突然起病提示有诱发因素。
研究人类疱疹病毒8型（HHV - 8）在2型糖尿病酮症倾向型发病机制中的潜在作用。
设计、地点和参与者：一项横断面研究，采用免疫荧光法检测针对HHV - 8潜伏和裂解抗原的抗体。在22名糖尿病临床发病参与者中研究基因组DNA中HHV - 8的存在情况。我们还检测了HHV - 8在体外培养的人胰腺β细胞中是否能够感染。该研究于2004年1月至2005年7月在法国巴黎圣路易大学医院进行。所有参与者均为黑人及非洲裔：187名连续的糖尿病患者，其中81例为2型糖尿病酮症倾向型，106例为非酮症2型糖尿病，90名非糖尿病对照参与者按年龄和性别匹配。
HHV - 8的血清阳性率以及2型糖尿病酮症倾向型发病时HHV - 8病毒血症患者的百分比。
在81例2型糖尿病酮症倾向型患者中有71例（87.7%）检测到HHV - 8抗体，而在106例非酮症2型糖尿病患者中有16例（15.1%）检测到（比值比，39.9；95%置信区间，17.1 - 93.4；P <.001），在90名对照参与者中有36例（40.0%）检测到（比值比，10.7；95%置信区间，4.9 - 23.4；P <.001）。在急性发病时检测的13例2型糖尿病酮症倾向型患者中有6例基因组DNA中存在HHV - 8，而9例非酮症2型糖尿病患者中无1例存在。在存在HHV - 8的情况下培养4天的人胰岛细胞中存在HHV - 8蛋白。
在这项初步的横断面研究中，撒哈拉以南非洲裔患者中HHV - 8抗体的存在与2型糖尿病酮症倾向型相关。需要进行纵向研究以了解这些发现的临床意义。
