糖尿病的临床异质性对精准分型诊断的挑战

The clinical heterogeneity of diabetes challenges the accuracy of typing diagnosis

糖尿病是一组由多因素复杂作用所致,包含多种病因和病理的临床综合征。不同糖尿病类型根据遗传学、免疫学、代谢和临床特征可有不同的内在型及复杂的临床表型。成人隐匿性自身免疫糖尿病与酮症倾向糖尿病是不同糖尿病类型之间临床异质性的体现。高度的临床异质性模糊了不同糖尿病类型的经典区别,导致糖尿病新分类的出现。糖尿病的高度异质性对精准分型诊断带来了挑战,而深刻认识不同糖尿病类型本身及其之间的异质性对疾病预测、预防、诊断和治疗具有重要意义。

Diabetes is a group of clinical syndromes with multiple causes and pathologies resulting from multiple factors.Different types of diabetes have different intrinsic types and complex clinical phenotypes according to genetics,immunology,metabolism,and clinical characteristics.Latent autoimmune diabetes in adults and ketosis-prone diabetes are the manifestation of clinical heterogeneity among different types of diabetes.High clinical heterogeneity gradually obscures the classic differences between diabetes types and leads to the emergence of new forms of diabetes.The high heterogeneity of diabetes poses challenges to the accurate classification of diabetes mellitus.It has significance in the prediction,prevention,diagnosis,and treatment of the disease for us to have a deep understanding of the clinical consequences of heterogeneity within and between different diabetes types.