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儿童糖尿病的临床和实验室特征:一项2000年至2013年的单中心研究

Clinical and Laboratory Characteristics of Childhood Diabetes Mellitus: A Single-Center Study from 2000 to 2013.

作者信息

Park Tae Hyun, Kim Min Sun, Lee Dae-Yeol

机构信息

Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Korea.

Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Korea.; Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Institute of Chonbuk National University Hospital, Jeonju, Korea.

出版信息

Chonnam Med J. 2016 Jan;52(1):64-9. doi: 10.4068/cmj.2016.52.1.64. Epub 2016 Jan 19.

Abstract

We examined the clinical and laboratory characteristics of children newly diagnosed with diabetes mellitus (DM) in a single-center study. We retrospectively reviewed the data of 155 children with DM between January 2000 and December 2013. Of 155 diabetic children, 87 (56.1%) were diagnosed with type 1 DM (T1DM) and 68 (43.9%) with type 2 DM (T2DM). Mean ages at diagnosis were 8.95±3.89 years (T1DM) and 13.76±2.23 years (T2DM), respectively (p<0.001). There were significant differences in HbA1c, C-peptide, and glutamic acid decarboxylase antibody levels between the T1DM and T2DM groups. Annual numbers of children with DM have increased, and since 2011 the number of children with T2DM has surpassed the number with T1DM. The most common clinical symptom in T1DM was polyuria, and 26.4% of children with T1DM presented initially with diabetic ketoacidosis. In contrast, 60.3% of T2DM children showed glucosuria in a school urine screening, and only 19.1% presented with polydipsia. The rate of positivity for at least more than one islet autoantibody was 77.1% in T1DM and 26.3% in T2DM. Serum C-peptide levels in T2DM were increased up to 12 months after onset and remained >3.59 ng/mL for 36 months. However, serum C-peptide levels in T1DM were slightly increased up to 6 months after onset and gradually decreased to 0.32 ng/mL for 36 months. The prevalence of children with DM has increased over the last 14 years, and the proportion of T2DM patients has rapidly increased since 2009. Because childhood DM is associated with several metabolic and cardiovascular complications, children should be screened for early detection of DM, especially asymptomatic T2DM in children and adolescents.

摘要

我们在一项单中心研究中检查了新诊断为糖尿病(DM)的儿童的临床和实验室特征。我们回顾性分析了2000年1月至2013年12月期间155例糖尿病患儿的数据。在155例糖尿病患儿中,87例(56.1%)被诊断为1型糖尿病(T1DM),68例(43.9%)被诊断为2型糖尿病(T2DM)。诊断时的平均年龄分别为8.95±3.89岁(T1DM)和13.76±2.23岁(T2DM)(p<0.001)。T1DM组和T2DM组之间的糖化血红蛋白、C肽和谷氨酸脱羧酶抗体水平存在显著差异。糖尿病患儿的年发病数量有所增加,自2011年以来,T2DM患儿的数量已超过T1DM患儿。T1DM最常见的临床症状是多尿,26.4%的T1DM患儿最初表现为糖尿病酮症酸中毒。相比之下,60.3%的T2DM患儿在学校尿液筛查中出现糖尿,只有19.1%表现为多饮。至少一种胰岛自身抗体的阳性率在T1DM中为77.1%,在T2DM中为26.3%。T2DM患者发病后12个月内血清C肽水平升高,并在36个月内保持>3.59 ng/mL。然而,T1DM患者发病后6个月内血清C肽水平略有升高,并在36个月内逐渐降至0.32 ng/mL。在过去14年中,糖尿病患儿的患病率有所增加,自2009年以来,T2DM患者的比例迅速上升。由于儿童糖尿病与多种代谢和心血管并发症相关,应筛查儿童以早期发现糖尿病,尤其是儿童和青少年中的无症状T2DM。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5763/4742612/ee8405ff3358/cmj-52-64-g001.jpg

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