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2型糖尿病的最新分子见解。

Newer molecular insights into type-2 diabetes mellitus.

作者信息

Khan Sikandar Hayat, Sarwar Urwa

机构信息

PNS Hafeez Hospital, Islamabad, Pakistan.

Islamabad Diagnostic Center, Islamabad, Pakistan.

出版信息

J Pak Med Assoc. 2020 Jun;70(6):1072-1075. doi: 10.5455/JPMA.20728.

Abstract

Beta cell function Type-2 diabetes mellitus (T2DM) has always been considered a heterogeneous and broad-spectrum disease with many associated complications and variations. Worthwhile in this regard were the findings that different individuals with T2DM label had slightly different set of clinical features and end-organ damage. Evidence is also there that pharmacotherapy related response also varies between individuals for the same category "T2DM". This report uses the existing molecular evidence to provide a suggested sub-classification for T2DM by using newly available molecular evidences from literature. The study broadly categorizes these T2DM with patients having primarily beta cell dysfunction or insulin resistance. While common features exists between T2DM subjects like hyperglycaemia and various organ damages, still the literature search highlight the subtle difference between the aforementioned two categories. Patients with insulin resistance can be clustered into obese, lipid/liver type and lipodystrophy associated features. Similarly, beta cell function can be associated with raised pro-insulin levels or otherwise.

摘要

β细胞功能 2型糖尿病(T2DM)一直被认为是一种具有多种相关并发症和变异的异质性广谱疾病。在这方面值得注意的是,患有T2DM的不同个体有一组略有不同的临床特征和终末器官损伤。也有证据表明,同一类“T2DM”患者之间的药物治疗相关反应也存在差异。本报告利用现有分子证据,结合文献中新获得的分子证据,为T2DM提供一种建议的亚分类。该研究大致将这些T2DM患者分为主要具有β细胞功能障碍或胰岛素抵抗的患者。虽然T2DM患者之间存在高血糖和各种器官损伤等共同特征,但文献检索仍突出了上述两类之间的细微差异。胰岛素抵抗患者可分为肥胖型、脂质/肝脏型和脂肪营养不良相关型。同样,β细胞功能可能与胰岛素原水平升高或其他情况有关。

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