不同起病年龄的1型糖尿病住院患者的临床特征

Clinical features for hospitalized type 1 diabetic patients with different ages of onset

目的:探讨1型糖尿病(type 1 diabetes,T1DM)住院患者的临床特征和并发症情况。方法:回顾性分析545例T1DM住院患者的临床资料,按照不同起病年龄(≤13岁、14~29岁、≥30岁)分析患者的临床特征和并发症情况。结果:545例T1DM患者的中位起病年龄为27.0(15.0,40.0)岁,≥30岁起病者占42.8%。与其他两组比较,≤13岁组女性比例(58.0%)较高,收缩压和血肌酐水平均最低,且所有微血管并发症的发生率(糖尿病肾病21.0%,糖尿病视网膜病变23.3%,糖尿病周围神经病变34.1%)均最低(均P<0.05);与其他两组比较,≥30岁组空腹C肽及峰值C肽水平均最低,起病时酮症的发生率(33.5%)及大血管并发症的发生率均最高(均P<0.05)。结论:在T1DM住院患者中≥30岁起病者约占一半,起病时酮症的发生率及起病后各种微血管及大血管并发症的风险均较<30岁起病者更高。

Objective:To explore the clinical features and complications of 545 hospitalized type 1 diabetic patients.Methods:All data of 545 patients with typical type 1 diabetes(T1DM)who were hospitalized in the Department of Endocrinology,the Second Xiangya Hospital,Central South University were collected.The data were analyzed retrospectively to explore the clinical features and complications.Clinical and biochemical characteristics were analyzed through comparison between different subgroups according to the onset age(≤13 years old,14–29 years old,≥30 years old).Results:The median onset age of T1DM patients was 27.0(15.0,40.0)years,and the middle-onset was 42.1%.Among the 3 groups,the proportion of female(58.0%)was the highest in the≤13years old group,concomitant with the lowest SBP and serum creatinine levels as well as the lowest incidence of all microvascular complications(21.0%of diabetic nephropathy,23.3%of diabetic retinopathy,34.1%of diabetic peripheral neuropathy;all P<0.05).Moreover,the fasting C peptide and peak C peptide levels were the lowest in≥30 years old group compared with the other two groups,and the incidence of ketosis(33.5%)and all macrovascular complications were the highest among the three groups(all P<0.05).Conclusion:There are about half of the hospitalized patients with T1DM whose onset ages are≥30 years.The incidence of ketosis at the onset and the risk for various microvascular and macrovascular complications after onset are higher than those with the onset age<30 years.