Non-Communicable Diseases Theme, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
Department of Medicine, Uganda Martyrs Hospital Lubaga, Kampala, Uganda.
BMJ Open Diabetes Res Care. 2024 Aug 29;12(4):e004174. doi: 10.1136/bmjdrc-2024-004174.
We undertook phenotypic characterization of early-onset and late-onset type 2 diabetes (T2D) in adult black African and white European populations with recently diagnosed T2D to explore ethnic differences in the manifestation of early-onset T2D.
Using the Uganda Diabetes Phenotype study cohort of 500 adult Ugandans and the UK StartRight study cohort of 714 white Europeans with recently diagnosed islet autoantibody-negative T2D, we compared the phenotypic characteristics of participants with early-onset T2D (diagnosed at <40 years) and late-onset T2D (diagnosed at ≥40 years).
One hundred and thirty-four adult Ugandans and 113 white Europeans had early-onset T2D. Compared with late-onset T2D, early-onset T2D in white Europeans was significantly associated with a female predominance (52.2% vs 39.1%, p=0.01), increased body mass index (mean (95% CI) 36.7 (35.2-38.1) kg/m vs 33.0 (32.4-33.6) kg/m, p<0.001), waist circumference (112.4 (109.1-115.6) cm vs 108.8 (107.6-110.1) cm, p=0.06), and a higher frequency of obesity (82.3% vs 63.4%, p<0.001). No difference was seen with the post-meal C-peptide levels as a marker of beta-cell function (mean (95% CI) 2130.94 (1905.12-2356.76) pmol/L vs 2039.72 (1956.52-2122.92), p=0.62).In contrast, early-onset T2D in Ugandans was associated with less adiposity (mean (95% CI) waist circumference 93.1 (89.9-96.3) cm vs 97.4 (95.9-98.8) cm, p=0.006) and a greater degree of beta-cell dysfunction (120 min post-glucose load C-peptide mean (95% CI) level 896.08 (780.91-1011.24) pmol/L vs 1310.10 (1179.24-1440.95) pmol/L, p<0.001), without female predominance (53.0% vs 57.9%, p=0.32) and differences in the body mass index (mean (95% CI) 27.3 (26.2-28.4) kg/m vs 27.9 (27.3-28.5) kg/m, p=0.29).
These differences in the manifestation of early-onset T2D underscore the need for ethnic-specific and population-specific therapeutic and preventive approaches for the condition.
我们对新诊断为 2 型糖尿病（T2D）的成年黑非洲人和白欧洲人进行了早发性和迟发性 T2D 的表型特征分析，以探讨早发性 T2D 表现的种族差异。
使用乌干达糖尿病表型研究队列中的 500 名成年乌干达人和约旦 714 名新诊断为胰岛自身抗体阴性 T2D 的白欧洲人，我们比较了早发性 T2D（<40 岁诊断）和迟发性 T2D（≥40 岁诊断）患者的表型特征。
134 名乌干达成年人和 113 名白欧洲人患有早发性 T2D。与迟发性 T2D 相比，白欧洲人的早发性 T2D 与女性居多（52.2%比 39.1%，p=0.01）、体重指数（平均值（95%CI）36.7（35.2-38.1）kg/m 比 33.0（32.4-33.6）kg/m，p<0.001）、腰围（112.4（109.1-115.6）cm 比 108.8（107.6-110.1）cm，p=0.06）更大，肥胖率更高（82.3%比 63.4%，p<0.001）。餐后 C 肽水平作为β细胞功能的标志物无差异（平均值（95%CI）2130.94（1905.12-2356.76）pmol/L 比 2039.72（1956.52-2122.92），p=0.62）。相比之下，乌干达人的早发性 T2D 与较低的肥胖程度（平均值（95%CI）腰围 93.1（89.9-96.3）cm 比 97.4（95.9-98.8）cm，p=0.006）和更大程度的β细胞功能障碍（120 分钟葡萄糖负荷后 C 肽平均值（95%CI）水平 896.08（780.91-1011.24）pmol/L 比 1310.10（1179.24-1440.95）pmol/L，p<0.001）相关，而与女性居多（53.0%比 57.9%，p=0.32）和体重指数差异（平均值（95%CI）27.3（26.2-28.4）kg/m 比 27.9（27.3-28.5）kg/m，p=0.29）无关。
早发性 T2D 表现的这些差异突出表明，需要针对特定种族和特定人群制定特定的治疗和预防方法。
