成人隐匿性自身免疫性糖尿病患者临床特征分析

Analysis on the clinical features of the LADA patients

目的分析LADA患者的临床特征,以提高对其的防治水平。方法选取临床新诊断的LADA患者51例作为试验组,同时选择50例新诊断T2DM患者作为对照组。所有研究对象均测量身高、体重、WHR、血压,并测定FPG、血脂、C-P、Ins、HbA1c,标准餐后2hPG、2hC-P。比较两组患者的胰岛素分泌指数(HOMA-β)和胰岛素抵抗指数(HOMA-IR)。结果 LADA发病年龄范围较广,部分LADA患者体形肥胖,伴有高血压和(或)血脂异常。试验组的HOMA-β低于T2DM组(P<0.05),两组间HOMA-IR比较差异无统计学意义(P>0.05)。结论 LADA患者临床表现具有很大的异质性。患者体内既存在胰岛素缺乏,又有IR。胰岛自身抗体检测有助于诊断,诊断后需要尽早使用胰岛素治疗,可配合应用胰岛素增敏剂治疗。

Objective To analyze the clinical characteristics of the latent autoimmune diabetes in adults （LADA）. Methods Fifty-one newly diagnosed LADA patients were enrolled and fifty newly diagnosed T2DM patients served as the control. The levels of HOMA-β and HOMA-IR in two groups were analyzed through the comparison of the height, weight, waist-hip ratio （WHR）, blood pressure （BP）, fasting plasma glucose（FPG）, blood lipids, C-peptide, insulin, HbAlc, and standard 2-hour postprandial plasma glucose （2 hPG） and fasting C-peptide （FC-P） in all subjects. Results Among the LADA patients there was a wide range of age,and some o{ them were obese with high blood pressure and/ or lipid abnormalities. HOMA-β was lower in LADA group than in T2DM group （P〈0. 05）, and the difference in HOMA-IR between the two groups was not significant （P〈0. 05）. Conclusions Clinical manifestations in LADA patients are significantly heterogenetic. The patients have both insulin deficiency and insulin resistance. The islet autoantibody test is heipful in diagnosis of LADA. Early application of insulin is needed and insulin sensitizer can be added to insulin treatment.