Unit of Pediatric Nephrology with Dialysis, AOU Policlinic G Martino, University of Messina, 98125 Messina, Italy.
Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy.
Medicina (Kaunas). 2021 Aug 25;57(9):868. doi: 10.3390/medicina57090868.
Youth-onset Type 2 Diabetes Mellitus (T2DM) represents a major burden worldwide. In the last decades, the prevalence of T2DM became higher than that of Type 1 Diabetes Mellitus (T1DM), helped by the increasing rate of childhood obesity. The highest prevalence rates of youth-onset T2DM are recorded in China (520 cases/100,000) and in the United States (212 cases/100,000), and the numbers are still increasing. T2DM young people present a strong hereditary component, often unmasked by social and environmental risk factors. These patients are affected by multiple coexisting risk factors, including obesity, hyperglycemia, dyslipidemia, insulin resistance, hypertension, and inflammation. Juvenile T2DM nephropathy occurs earlier in life compared to T1DM-related nephropathy in children or T2DM-related nephropathy in adult. Diabetic kidney disease (DKD) is T2DM major long term microvascular complication. This review summarizes the main mechanisms involved in the pathogenesis of the DKD in young population and the recent evolution of treatment, in order to reduce the risk of DKD progression.
青少年 2 型糖尿病（T2DM）是全球范围内的一个主要负担。在过去几十年中，由于儿童肥胖率的增加，T2DM 的患病率高于 1 型糖尿病（T1DM）。青少年 T2DM 的最高患病率记录在中国（520 例/10 万）和美国（212 例/10 万），且这一数字仍在不断增加。T2DM 年轻人具有很强的遗传成分，常常被社会和环境风险因素所掩盖。这些患者受到多种共存风险因素的影响，包括肥胖、高血糖、血脂异常、胰岛素抵抗、高血压和炎症。与儿童期 T1DM 相关的肾病或成人期 T2DM 相关的肾病相比，青少年 T2DM 肾病在生命早期发生。糖尿病肾病（DKD）是 T2DM 主要的长期微血管并发症。本综述总结了青少年人群 DKD 发病机制中的主要机制以及最近的治疗进展，以期降低 DKD 进展的风险。
