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巴西1型糖尿病患者确诊3年后的残余β细胞功能:患病率及其与低肾病发生率的关联

Residual β-cell function in Brazilian Type 1 diabetes after 3 years of diagnosis: prevalence and association with low presence of nephropathy.

作者信息

Gabbay Monica A L, Crispim Felipe, Dib Sergio A

机构信息

Centre for Diabetes, Endocrinology Division, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.

Molecular Biology Laboratory, Endocrinology Division, Department of Medicine Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.

出版信息

Diabetol Metab Syndr. 2023 Mar 20;15(1):51. doi: 10.1186/s13098-023-01014-z.

Abstract

BACKGROUND

Persistence of β cell-function in Type 1 diabetes (T1D) is associated with glycaemia stability and lower prevalence of microvascular complications. We aimed to assess the prevalence of residual C- peptide secretion in long-term Brazilian childhood onset T1D receiving usual diabetes care and its association to clinical, metabolic variables and microvascular complications.

METHODS

A cross-sectional observational study with 138 T1D adults with ≥ 3 years from the diagnosis by routine diabetes care. Clinical, metabolic variables and microvascular complications were compared between positive ultra-sensitive fasting serum C-peptide (FCP +) and negative (FCP-) participants.

RESULTS

T1D studied had ≥ 3 yrs. of diagnosis and 60% had FCP > 1.15 pmol/L. FCP + T1D were older at diagnosis (10 vs 8 y.o; p = 0.03) and had less duration of diabetes (11 vs 15 y.o; p = 0.002). There was no association between the FCP + and other clinical and metabolic variable but there was inversely association with microalbuminuria (28.6% vs 13.4%, p = 0.03), regardless of HbA. FCP > 47 pmol/L were associated with nephropathy protection but were not related to others microvascular complications.

CONCLUSION

Residual insulin secretion is present in 60% of T1D with ≥ 3 years of diagnosis in routine diabetes care. FCP + was positively associated with age of diagnosis and negatively with duration of disease and microalbuminuria, regardless of HbA.

摘要

背景

1型糖尿病(T1D)患者β细胞功能的持续存在与血糖稳定性及微血管并发症的较低患病率相关。我们旨在评估在接受常规糖尿病护理的巴西长期儿童期起病的T1D患者中残余C肽分泌的患病率及其与临床、代谢变量和微血管并发症的关联。

方法

一项横断面观察性研究,纳入138例经常规糖尿病护理诊断≥3年的T1D成年患者。比较超敏空腹血清C肽阳性(FCP+)和阴性(FCP-)参与者的临床、代谢变量和微血管并发症。

结果

所研究的T1D患者诊断时间≥3年,60%的患者FCP>1.15 pmol/L。FCP+的T1D患者诊断时年龄较大(10岁对8岁;p=0.03),糖尿病病程较短(11岁对15岁;p=0.002)。FCP+与其他临床和代谢变量之间无关联,但与微量白蛋白尿呈负相关(28.6%对13.4%,p=0.03),与糖化血红蛋白无关。FCP>47 pmol/L与肾病保护相关,但与其他微血管并发症无关。

结论

在接受常规糖尿病护理且诊断≥3年的T1D患者中,60%存在残余胰岛素分泌。无论糖化血红蛋白如何,FCP+与诊断年龄呈正相关,与疾病病程和微量白蛋白尿呈负相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17ee/10026390/ea39617aaa9f/13098_2023_1014_Fig1_HTML.jpg

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