成人晚发自身免疫性糖尿病的临床及代谢特征

Clinical and metabolism feature of latent autoimmune diabetes mellitus in adults

为探讨成人晚发自身免疫性糖尿病 (L ADA)的临床及代谢特征 ,为临床早期发现本病提供依据 ,以胰岛细胞自身抗体 (ICA)阳性为 L ADA主要诊断依据 ,将其临床表现与速发型 1型糖尿病 (DM1)、2型糖尿病(DM2 )进行比较。结果显示 ,L ADA的临床特征为 :1发病年龄 >2 5岁 ,多在 45岁左右 ;2胰岛 β细胞功能比正常人低下 ,但明显高于 DM1,C肽释放曲线与 DM2患者相似 ,但绝对值较低 ;3具有与 DM1相似的免疫学特征 ,ICA阳性 ;4酮症出现时间明显迟于 DM1患者 ,多数患者发病 1.5年之内无酮症。提示 L ADA为免疫介导的自身免疫性疾病 ,其本质为胰岛素β细胞的免疫性损伤 ,根据上述特征可早期发现本病。

To study the clinical and metablism feature of latent autoimmune diabetes mellitus in adults(LADA),to identify the disease in earlier period According to positive islet cell antibody(ICA)to obtain the diagnosis of LADA,by comparing with immediate type 1 diabetes mellitus(DM1)and type 2 diabetes mellitus(DM2)to find the feature of LADA Results showed that the clinical features of LADA were that the age of illness onset was over 25,most of them were about 45,the function of beta cell of islet was lower than that of normal person,but significantly higher than that of immediate DM1 C peptide releasing curve of LADA was similar to DM2 excepting for lower absolute value Similar to immunology abnormality in immediate DM1,ICA was positive The onset of diabetic ketosis was significantly later than that of immediate type DM1,most of patients didn′t developed ketosis in 1 5 years The clinical feature of LADA suggest that LADA is a autoimmune disease,it′s pathogenesis is immunity damage in beta cell of islet,identifying the disease in earlier period is advantageous in improving prognosis