Tulloch-Reid M K, Boyne M S, Smikle M F, Choo-Kang E G, Parkes R H, Wright-Pascoe R A, Barton E N, Wilks R J, Williams D E
The Tropical Medicine Research Institute, The University of the West Indies, Kingston 7, Jamaica, West Indies.
West Indian Med J. 2009 Jun;58(3):219-26.
To assess the effect of diabetes mellitus type on conventional and novel cardiovascular risk factors in patients, diagnosed with diabetes from two major referral hospitals in Jamaica, before age 25 years and with diabetes duration < 6 years.
Participants were classified based on the presence of GAD-65 and IA-2 autoantibodies, C-peptide, leptin and clinical phenotype. Trained observers obtained anthropometric measurements and sitting blood pressure. Fasting blood was taken for glucose, A1c, lipids, high sensitivity C-reactive protein and lipoprotein profile.
Fifty-eight participants (21M; 37F age 20 +/- 8 [Mean +/- SD] years, diabetes duration 2.6 +/- 2 years) were enrolled. Thirty-six had Type 1 diabetes (T1D), thirteen Type 2 diabetes (T2D), six were not typed and three had lipoatrophic diabetes. Patients with Type 2 diabetes (T2D) were more obese with a higher systolic blood pressure but a lower A1c than those with Type 1 diabetes (T1D). Total cholesterol, LDL-cholesterol, triglycerides, VLDL, LDL and HDL particle numbers were similar in patients with T1D and T2D. HDL-cholesterol and LDL and HDL particle sizes were lower in patients with T2D but differences were no longer significant after adjusting for BMI.
Risk factors for cardiovascular disease are common in patients with all forms of youth onset diabetes. Clinicians should therefore investigate these risk factors in their patients regardless of diabetes type.
评估糖尿病类型对来自牙买加两家主要转诊医院、25岁前确诊糖尿病且糖尿病病程<6年的患者的传统和新型心血管危险因素的影响。
根据谷氨酸脱羧酶65（GAD-65）和胰岛抗原2（IA-2）自身抗体、C肽、瘦素的存在情况及临床表型对参与者进行分类。训练有素的观察者进行人体测量和坐位血压测量。采集空腹血样检测血糖、糖化血红蛋白（A1c）、血脂、高敏C反应蛋白和脂蛋白谱。
共纳入58名参与者（21名男性；37名女性，年龄20±8[均值±标准差]岁，糖尿病病程2.6±2年）。其中36人患有1型糖尿病（T1D），13人患有2型糖尿病（T2D），6人未分型，3人患有脂肪萎缩性糖尿病。2型糖尿病（T2D）患者比1型糖尿病（T1D）患者更肥胖，收缩压更高，但A1c更低。1型糖尿病（T1D）和2型糖尿病（T2D）患者的总胆固醇、低密度脂蛋白胆固醇、甘油三酯及极低密度脂蛋白、低密度脂蛋白和高密度脂蛋白颗粒数量相似。2型糖尿病（T2D）患者的高密度脂蛋白胆固醇以及低密度脂蛋白和高密度脂蛋白颗粒大小较低，但在调整体重指数（BMI）后差异不再显著。
所有形式的青年期糖尿病患者中，心血管疾病危险因素均很常见。因此，临床医生应在其患者中对这些危险因素进行调查，而不论糖尿病类型如何。
