Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Beijing, China.
J Diabetes Complications. 2012 Jan-Feb;26(1):40-3. doi: 10.1016/j.jdiacomp.2011.11.009. Epub 2012 Jan 5.
The purpose was to characterize the clinical, biochemical, and immunological features of newly diagnosed adult-onset nonobese diabetic patients in China.
Newly diagnosed diabetic patients aged 18-45 years with body mass index<23 kg/m(2) were included. Excluding one mitochondrial diabetes patient, there were 102 diabetic patients enrolled in this study. Clinical and biochemical data were collected and analyzed. Radioimmunoassay was used to detect islet autoantibodies.
Among the 102 study participants, 68.6% had type 1 diabetes (T1DM), 20.6% had type 2 diabetes (T2DM), and 10.8% had latent autoimmune diabetes in adults (LADA). About 92% of the T1DM patients presented hyperglycemic symptoms. The corresponding number in T2DM and LADA patients was 13% and 38%, respectively (P<.01). C-peptide in T2DM patients (1.4±0.7 ng/ml) was significantly higher than that in T1DM (0.4±0.3 ng/ml) and LADA (0.4±0.2 ng/ml) patients (P<.01). The prevalence of glutamic acid decarboxylase antibody (GADA) (64.3%) in T1DM patients was higher than that of insulin autoantibody (17.1%) (P<.05). GADA and islet cell antibody (ICA) combination was positive in 75.7% of T1DM patients.
T1DM patients accounted for majority of the study sample. In addition, the clinical symptoms of T1DM patients were more severe compared with T2DM patients. GADA is the most sensitive autoantibody marker for adult-onset T1DM and LADA. GADA and ICA are the best test combination for adult-onset autoimmune diabetes. Specific types of diabetes should be in mind when diabetes presents itself with special transmission mode or with other extrapancreatic manifestations.
本研究旨在描述中国新诊断的成年起病的非肥胖型糖尿病患者的临床、生化和免疫学特征。
纳入新诊断的年龄 18-45 岁、体重指数（BMI）<23kg/m2的糖尿病患者。排除线粒体糖尿病患者后，共纳入 102 例糖尿病患者。收集并分析其临床和生化数据，采用放射免疫法检测胰岛自身抗体。
102 例研究对象中，68.6%为 1 型糖尿病（T1DM），20.6%为 2 型糖尿病（T2DM），10.8%为成人隐匿性自身免疫性糖尿病（LADA）。约 92%的 T1DM 患者以高血糖症状起病，T2DM 和 LADA 患者分别为 13%和 38%（P<.01）。T2DM 患者的 C 肽（1.4±0.7ng/ml）显著高于 T1DM（0.4±0.3ng/ml）和 LADA（0.4±0.2ng/ml）患者（P<.01）。T1DM 患者谷氨酸脱羧酶抗体（GADA）（64.3%）的阳性率高于胰岛素自身抗体（17.1%）（P<.05）。75.7%的 T1DM 患者 GADA 与胰岛细胞抗体（ICA）同时阳性。
本研究中 T1DM 患者占多数，且其临床症状较 T2DM 患者更为严重。GADA 是诊断成人起病的 T1DM 和 LADA 的最敏感的自身抗体标志物，GADA 和 ICA 是诊断成人自身免疫性糖尿病的最佳联合检测。当糖尿病以特殊的传播方式或伴有其他胰外表现时，应考虑到具体的糖尿病类型。
