1型糖尿病与自身免疫多腺体综合征

Type 1 diabetes and polyglandular autoimmune syndrome

1型糖尿病(type 1 diabetes mellitus,T1DM)是由胰腺组织炎性破坏引起的一种自身免疫病。由于T1DM与自身免疫多腺体综合征(APS)可能有共同的易感基因,故T1DM患者常合并其他自身免疫性疾病。APS可分为I-IV型,各型中均可包含T1DM,其中以APSⅢ型[T1DM与自身免疫性甲状腺病(AITD)共存]最常见。因此,所有初发的和每两年一次复查的T1DM患者,均需要对其他内分泌腺体和胃肠病做血清学和功能筛查,以及早发现尚未出现临床症状的APS。一旦发生APS,T1DM患者的胰岛素治疗和血糖控制将受到影响。因此,必须根据具体情况调整治疗方案。

Type 1 diabetes mellitus （T1DM） is an autoim-mune disorder caused by inflammatory destruction of the pan- creatic tissue. On account of the fact that T1DM and polyglandular autoimmune syndrome （APS） probably have common susceptibility genes, T1DM often occurs in conjunction with several autoimmune endocrine and non-endocrine diseases. APS, characterized by a combination of at least two autoimmune endocrinopathies, can be classified into type I-IV, and T1DM is within type of APS. TypeⅢ （autoimmune thyroid disease in combination with T1DM） is the most frequent subtype of APS. In isolation as a monoglandular disease, or within the larger context of APS, the manifestation of T1DM justifies an extensive serologic and functional screening for additional au- toimmune glandular and gastrointestinal diseases in patients with T1DM of recent onset as well as every two years during patients follow-up. Clinicians should pay particular attention to autoim- mune endoerinopathies, which are associated with T1DM and strongly impact the patients treatment with insulin.