Zhou Yun-Xia, Tan Hui-Wen, Yu Ye-Rong
Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2013 Nov;44(6):950-3.
To evaluate the clinical features and epidemiological trend of diabetes ketosis (DK) in patients admitted to West China Hospital.
We reviewed medical records of diabetic patients with DK who were admitted to West China Hospital from 1997 to 2005. Their clinical and laboratory data were analysed with SAS 9.0.
From 1997 to 2005, the proportion of diabetic patients with DK increased by 0.12% annually. The proportion of provoked DK patients (who had a clinically evident precipitating factor) in those with DK remained stable; whereas the proportion of T1D patients in those with DK declined by 2.00% annually and the proportion of ketosis prone obesity diabetes (KPD) in those with DK increased by 2.27% annually. The KPD patients displayed a striking male predominance (2.31:1, male:female) and were diagnosed at an older age compared with those with T1D [(46.3 +/- 12.9) yr. vs. (28.9 +/- 14.7) yr.]. The KPD patients were more likely to have a strong family history of diabetes and a better beta-cell function reserve, and be accompanied with dyslipidemia (52.7%), hypertension (23.3%), fatty liver (10.1%) and hyperuricemia/gout (8. 5%) compared with those with T1D.
In recent years the proportion of KPD patients in the hospitalized DK patients is increasing. With different characteristics compared with typical T1D, KPD might belong to a subgroup of T2D.
评估四川大学华西医院收治的糖尿病酮症(DK)患者的临床特征及流行病学趋势。
回顾性分析1997年至2005年在四川大学华西医院住院的糖尿病酮症患者的病历资料,应用SAS 9.0软件分析其临床及实验室数据。
1997年至2005年,糖尿病酮症患者的比例每年增长0.12%。酮症诱发因素明确的DK患者比例保持稳定;而DK患者中1型糖尿病(T1D)患者的比例每年下降2.00%,酮症倾向型肥胖糖尿病(KPD)患者的比例每年增长2.27%。KPD患者男性占主导(男∶女为2.31∶1),与T1D患者相比,确诊年龄较大[(46.3±12.9)岁对(28.9±14.7)岁]。与T1D患者相比,KPD患者更易有糖尿病家族史,β细胞功能储备更好,且更易伴有血脂异常(52.7%)、高血压(23.3%)、脂肪肝(10.1%)及高尿酸血症/痛风(8.5%)。
近年来,住院DK患者中KPD患者的比例呈上升趋势。KPD与典型T1D具有不同特点,可能属于2型糖尿病(T2D)的一个亚组。