Ganda O P, Soeldner S S
Arch Intern Med. 1977 Apr;137(4):461-9.
Diabetes mellitus is not a single disease entity, but a heterogenous group of disorders with a striking diversity of etiopathogenetic mechanisms as well as clinical manifestations. Lack of a known genetic marker for the disease(s) and variable influences of environmental factors on the expression of a putative diabetic genome have resulted in considerable debate over its etiology. Over the past few years, systematic epidemiologic studies, along with knowledge gained from a close association of certain human-leukocyte-antigens with the diabetic diathesis and possible role of host-immune factors, and gene-virus interaction have led to considerable advancement in the understanding of the disease-complex. Pending the availability of definite genetic marker(s), we propose a new, tentative classification based on the etiologic mechanisms. We also suggest that the term "prediabetes" be abandoned as a prospective entity, since as presently employed, this connotation carries a risk probability no different than the terms like prehypertension or precoronary thrombosis.
糖尿病并非单一的疾病实体，而是一组异质性疾病，其病因发病机制及临床表现具有显著的多样性。由于缺乏该疾病已知的遗传标记，以及环境因素对假定的糖尿病基因组表达的可变影响，导致了对其病因的大量争论。在过去几年中，系统的流行病学研究，以及从某些人类白细胞抗原与糖尿病素质的密切关联中获得的知识、宿主免疫因素的可能作用以及基因 - 病毒相互作用，使我们对这种复杂疾病的理解有了相当大的进展。在确定的遗传标记可用之前，我们基于病因机制提出一种新的、暂定的分类。我们还建议放弃将“糖尿病前期”作为一个前瞻性实体的术语，因为按照目前的使用方式，这个概念所携带的风险概率与诸如高血压前期或冠状动脉血栓形成前期等术语并无不同。
