成人隐匿性自身免疫糖尿病与2型糖尿病血管并发症对比分析

Comparison of vascular complications between the latent autoimmune diabetes in adults and type 2 diabetes

目的比较成人隐匿性自身免疫糖尿病(LADA)与2型糖尿病(T2DM)的临床及代谢特征,探讨两者微血管和大血管并发症的差异。方法比较48例LADA患者与55例T2DM患者的血压、血脂、体质量指数、空腹血糖、糖化血红蛋白(Hb A1c)、C肽、颈部血管及下肢血管B超检查结果、眼底检查、尿微量白蛋白的差异。结果入院时LADA组与T2DM组相比较,在体质量指数、血压、血脂、C肽释放水平低(P<0.05);在脑梗死、颈部和下肢血管斑块的患病率上,LADA组较T2DM组低(P<0.05);两组在糖尿病肾病、糖尿病视网膜病变的患病率差异无统计学意义(P>0.05)。结论 LADA患者在早期即出现血管并发症,与T2DM相比,LADA在微血管病变比大血管病变更严重。

Objective This study aimed to assess the clinical characteristics and the prevalence of microvascu-lar and macrovascular complications in latent autoimmune diabetes in adults （LADA）and type 2 diabetes （T2DM）. Methods Blood pressure,lipids,body mass index （BMI）,fasting plasma glucose,glycosylated hemoglobin,C peptide, neck blood vessels and lower extremity arteries B ultrasound,fundus examination as well as urine micro albumin were compared.Between 48 patients with LADA and 55 patients with type 2 diabetes.Results Compared patients with T2DM,patients with LADA was at a lower level in BMI,blood pressure,lipids and C peptide release （P〈0.05）.LADA patients had lower prevalence of Cerebral infarction,neck and lower extremity vascular plaque （P〈0.05）.Similar prev-alence of diabetic nephropathy and diabetic retinopathy （P〉0.05）were found between LADA patients and T2DM. Conclusion LADA patients show vascular complications in the early stage.Compared with T2DM,LADA has a higher prevalence of microvascular complications than macrovascular complications.