Ogawa Wataru, Araki Eiichi, Ishigaki Yasushi, Hirota Yushi, Maegawa Hiroshi, Yamauchi Toshimasa, Yorifuji Tohru, Katagiri Hideki
Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan.
Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honso, Chuo-ku, Kumamoto, 860-8556 Japan.
Diabetol Int. 2022 Jan 31;13(2):337-343. doi: 10.1007/s13340-022-00570-5. eCollection 2022 Apr.
This report of a working group established by the Japan Diabetes Society proposes a new classification and diagnostic criteria for insulin resistance syndrome. Insulin resistance syndrome is defined as a condition characterized by severe attenuation of insulin action due to functional impairment of the insulin receptor or its downstream signaling molecules. This syndrome is classified into two types: genetic insulin resistance syndrome, caused by gene abnormalities, and type B insulin resistance syndrome, caused by autoantibodies to the insulin receptor. Genetic insulin resistance syndrome includes type A insulin resistance as well as Donohue and Rabson-Mendenhall syndromes, all of which are caused by abnormalities of the insulin receptor gene; conditions such as SHORT syndrome caused by abnormalities of , which encodes a regulatory subunit of phosphatidylinositol 3-kinase; conditions caused by abnormalities of , , or ; and conditions in which a causative gene has not yet been identified. Type B insulin resistance syndrome is characterized by severe impairment of insulin action due to the presence of insulin receptor autoantibodies. Cases in which hypoglycemia alone is induced by autoantibodies that stimulate insulin receptor were not included in Type B insulin resistance syndrome.
这份由日本糖尿病学会成立的工作组报告提出了胰岛素抵抗综合征的新分类和诊断标准。胰岛素抵抗综合征被定义为一种由于胰岛素受体或其下游信号分子功能受损导致胰岛素作用严重减弱的病症。该综合征分为两种类型：由基因异常引起的遗传性胰岛素抵抗综合征，以及由胰岛素受体自身抗体引起的B型胰岛素抵抗综合征。遗传性胰岛素抵抗综合征包括A型胰岛素抵抗以及多诺霍综合征和拉布森 - 门登霍尔综合征，所有这些均由胰岛素受体基因异常引起；由编码磷脂酰肌醇3 - 激酶调节亚基的基因异常引起的SHORT综合征等病症；由其他基因异常引起的病症；以及尚未确定致病基因的病症。B型胰岛素抵抗综合征的特征是由于存在胰岛素受体自身抗体导致胰岛素作用严重受损。仅由刺激胰岛素受体的自身抗体诱发低血糖的病例不包括在B型胰岛素抵抗综合征中。
