急性型1型糖尿病临床特征的性别差异研究

Gender Differences in Clinical Features of Acute Type 1 Diabetes Mellitus

目的研究比较急性型1型糖尿病患者的胰岛功能及自身抗体等临床特征有无性别差异。方法利用SPSS软件分析2002-2007年我院收治的193例该病患者资料。结果患者男女比例为1.6∶1,在入院年龄、空腹血糖、糖化血红蛋白(HBA1c)和血胰岛自身抗体阳性率及并发神经病变等方面无性别差异。但与男性相比,女性发病更早、入院时病程更长、空腹C肽水平更低、发生过酮症酸中毒者比例更高;14岁(青春期)前起病者上述指标无性别差异,14岁以后发病者女性较男性的病程更长、空腹C肽水平更低;14岁后发病的男性空腹C肽水平明显高于14岁前起病者,而14岁后发病女性的胰岛自身抗体总阳性率及周围神经病变患病率明显高于14岁前起病者。结论青春期以后急性起病的1型糖尿病患者在某些临床特征上可能存在性别差异,性激素可能是其重要影响因素之一。

Objective To analyze whether there are any gender differences in clinical features of acute type 1 diabetes mellitus. Methods Clinical data of 193 patients with acute type 1 diabetes mellitus were collected in our hospital from 2002 to 2007,and subjected to statistical analysis by SPSS. Results The ratio of male to female in all the subjects was 1.6：1. There was no significant gender difference in such clinical aspects as age,fasting blood glucose level,HbA1c concentration,positive percentage of serum autoantibodies against pancreatic islet or morbidity of diabetic neuropathy. In contrast to the males,the onset age was significantly younger,the diabetic duration longer,fasting serum C peptide level lower and the incidence of ketotic acidosis higher in female patients. The patients with onset age less than 14 years（puberty） did not show any significant gender differences in the above-mentioned clinical aspects. Among those with onset age more than 14 years,the females had significantly longer duration and lower fasting serum C peptide level than males. The male patients with onset age more than 14 years had significantly higher fasting serum C peptide level than those less than 14,whereas it was the same for total positive percentages of pancreatic islet autoantibodies and morbidity of diabetic neuropathy in females. Conclusion Gender differences may exist in some clinical features of type 1 diabetic patients with acute onset after puberty,which may partially result from the effects of sex hormones.