儿童和青少年1型糖尿病胰岛细胞功能评估方法

Assessment of islet cell function in children and adolescents with type 1 diabetes

1型糖尿病的发病主要源于T细胞介导的胰岛细胞特异性免疫损伤,具有C肽和胰岛素降低、糖尿病相关抗体阳性、糖尿病酮症酸中毒常见、依赖胰岛素治疗等特征。临床实践中部分糖尿病患儿特征不典型,糖尿病分型困难,胰岛β细胞功能的评估为分型提供重要依据。该文通过汇总β细胞功能评估方法的比较,包括葡萄糖耐量试验(OGTT)、血清C肽、胰岛素生成指数等,以期提高对儿童青少年1型糖尿病患儿残存的胰岛功能的评估能力,提升糖尿病患儿的鉴别水平,更好地指导儿童青少年1型糖尿病患儿的治疗和随访。

Type 1 diabetes is mainly caused by T cell-mediated islet cell-specific immune damage.The characteristics include decreased C-peptide and insulin,positive diabetes-related antibodies,more diabetic ketoacidosis,and dependence on insulin therapy.In clinical practice it is difficult to classify type 1 and type 2 diabetes in some children and adolescents due to atypical clinical features.The assessment of isletβcell function provides an important evidence for the classification.This article summarizes the evaluation methods of isletβcell function,including oral glucose tolerance test,serum C-peptide and insulin production index,aiming to improve the ability to evaluate residual islet function in patients with type 1 diabetes,increase the level in identifying diabetes children,and provide better guidance to the treatment and follow-up of children with type 1 diabetes.