酮症倾向糖尿病临床特征的荟萃分析

Ketosis-prone diabetes vs.non-ketosis type 2 diabetes:A meta-analysis of comparative studies

目的:分析酮症倾向糖尿病(KPD)临床特征,为预防及临床治疗KPD提供依据。方法:计算机检索PubMed、The Cochrane Library、EMBASE、CBM、中国知网及万方数据库,检索时限均为建库至2020年2月,收集KPD与非酮症2型糖尿病(T2DM)患者的临床病历资料,进行病例对照研究,由2位研究者按照纳入和排除标准独立筛选文献、提取资料和评价质量后,用STATA 12.0软件进行Meta分析。结果:共纳入12篇文献,其中717例KPD患者,1010例非酮症T2DM患者;Meta分析显示,与非酮症2型糖尿病患者比较,KPD患者平均年龄较小,糖化血红蛋白水平较高,空腹C肽水平较低,且男性患者数量较多(均P<0.01),另外KPD患者甘油三酯水平较高(P=0.00),总胆固醇水平较低(P=0.017),低密度脂蛋白水平也较低(P=0.061)。结论:与非酮症型T2DM患者比较,KPD患者具有平均年龄较小、男性发病率较高、血糖水平较高、胰岛功能较差和血脂紊乱程度不同的特点。

Objective:To assess the clinical features of ketosis-prone diabetes(KPD).Methods:We searched the PubMed,EMBASE and Cochrane Library,CBM,CNKI and WanFang databases for relevant articles.All statistical analyses were performed using the STATA version 12.0.The standardized mean difference(SMD)and odds ratio(OR)were used to compare continuous and dichotomous variables.Results:Twelve studies involving 717 KPD and 1010 non-ketosis type 2 diabetic mellitus(T2DM)were included.The results showed that KPD patients were younger(P=0.000)and had higher HbA1c(P=0.000)and lower FCP level(P=0.000)and the number of males in KPD was larger(P=0.000).In addition,the degree of dyslipidemia was also statistically significant(P=0.061).Conclusion:KPD patients are characterized by younger age,higher proportion of males,higher blood glucose,poorer islet function than non-ketosis T2DM patients.