Dai Yang-Li, Fu Jun-Fen, Liang Li, Dong Guan-Ping
Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2010 Nov;12(11):849-54.
To review the incident status of childhood type 1 diabetes mellitus hospitalized in the Children's Hospital of Zhejiang University School of Medicine from 1999 to 2009 and to explore the clinical value of IL-10 in diabetic ketoacidosis.
The clinical data of 263 children with type 1 diabetes mellitus hospitalized in the Children's Hospital of Zhejiang University School of Medicine from January 1999 to February 2009 were retrospectively reviewed. Serum lipid levels were measured in 48 children with type 1 diabetes mellitus and in 24 healthy children. The diabetic children were classified into two subgroups, with or without ketoacidosis. Serum lipid and cytokines levels were compared.
Childhood type 1 diabetes mellitus was common in females (56.3%). The peak incident age of the disease was between 6 and 11.9 years. Diabetic ketoacidosis was as the presenting symptom for the first visit in 86 cases (32.7%). The levels of serum lipid, blood glucose and HbA1c in diabetic children with ketoacidosis were significantly higher than those without ketoacidosis (P<0.05). Logistic analysis demonstrated that the increased levels of blood glucose, serum lipid and HbA1c were risk factors for diabetic ketoacidosis. The level of serum IL-10 in diabetic children with ketoacidosis was significantly higher than that in patients without ketoacidosis (P<0.01), while there were no differences in serum levels IL-2, IL4, IL-6, TNF-α and IFN-γ between them. Serum levels IL-2, IL-4, IL-6, IL-10, TNF-α and IFN-γ in diabetic children were significantly higher than those in healthy children (P<0.01).
Ketoacidosis is a common acute complication of type 1 diabetes mellitus. The disorders of glucose and lipid metabolism are the risk factors for ketoacidosis in diabetic children. IL-10 may be a sensitive index of diabetic ketoacidosis in children with type 1 diabetes mellitus.
回顾1999年至2009年浙江大学医学院附属儿童医院收治的儿童1型糖尿病发病情况，并探讨白细胞介素-10在糖尿病酮症酸中毒中的临床价值。
回顾性分析1999年1月至2009年2月在浙江大学医学院附属儿童医院住院的263例儿童1型糖尿病患者的临床资料。检测48例1型糖尿病患儿和24例健康儿童的血脂水平。将糖尿病患儿分为有或无酮症酸中毒两个亚组，比较血脂和细胞因子水平。
儿童1型糖尿病在女性中较为常见（56.3%）。该病的发病高峰年龄在6至11.9岁之间。86例（32.7%）以糖尿病酮症酸中毒作为首次就诊的表现症状。有酮症酸中毒的糖尿病患儿的血脂、血糖和糖化血红蛋白水平显著高于无酮症酸中毒的患儿（P<0.05）。逻辑分析表明，血糖、血脂和糖化血红蛋白水平升高是糖尿病酮症酸中毒的危险因素。有酮症酸中毒的糖尿病患儿的血清白细胞介素-10水平显著高于无酮症酸中毒的患儿（P<0.01），而两者之间血清白细胞介素-2、白细胞介素-4、白细胞介素-6、肿瘤坏死因子-α和干扰素-γ水平无差异。糖尿病患儿的血清白细胞介素-2、白细胞介素-4、白细胞介素-6、白细胞介素-10、肿瘤坏死因子-α和干扰素-γ水平显著高于健康儿童（P<0.01）。
酮症酸中毒是1型糖尿病常见的急性并发症。糖脂代谢紊乱是糖尿病患儿发生酮症酸中毒的危险因素。白细胞介素-10可能是1型糖尿病患儿糖尿病酮症酸中毒的一个敏感指标。
