Diabetes Metab Syndr Obes:中国2万新确诊糖尿病分析,3.72%为自身免疫性糖尿病

2019-11-13 卢芳 中国循环杂志

一提1型糖尿病,常常会认为患者多为儿童,但近期中南大学湘雅二医院周智广团队进行的研究发现,成人中也并不少见,尤其是自身免疫性糖尿病(LADA)。

一提1型糖尿病,常常会认为患者多为儿童,但近期中南大学湘雅二医院周智广团队进行的研究发现,成人中也并不少见,尤其是自身免疫糖尿病(LADA)。

这项在近2万新诊糖尿病患者中进行的研究显示,1型糖尿病患病率为5.49%,其中男性为5.14%,女性为6.16%,而1型糖尿病患者中,65%为LADA。

如果以2010年全国糖尿病流行病学调查中年龄和性别分布来计算,1型糖尿病年龄标化患病率为5.14%,LADA年龄标化患病率为3.72%。

这项研究也发现了LADA和经典1型糖尿病的一些不同,比如相较于经典1型糖尿病患者,LADA患者年龄、体重指数、腰围更大,超重或肥胖比例及血压更高,不过这些均低于非1型糖尿病患者。

在超重和肥胖糖尿病患者中,1型糖尿病患病率分别为3.42%和2.42%;而LADA在这两组1型糖尿病患者比例分别占76.5%和79.2%。

此外,不同于经典1型糖尿病患者随年龄增长而患病率降低,LADA则在不同年龄段的患病率较稳定。

这提示,LADA在年龄偏大和肥胖糖尿病患者更为常见。

在治疗方面,研究者发现,LADA患者更多用降压药、二甲双胍和磺脲类降糖药,而较少接受强化血糖治疗和基础胰岛素治疗。而实际上及时启动胰岛素治疗对于维持良好血糖至关重要。

值得注意的是,中国目前有7960万新诊糖尿病,如果按此研究患病率推算,则有430万LADA患者和240万胰岛素依赖性的经典1型糖尿病患者。

研究者指出,临床上多将LADA治疗等同于2型糖尿病,应该将胰岛自身抗体检测常规化,以给予患者适当治疗,更好控制血糖降低大血管和微血管并发症。不过基于患者较为众多,检测成本效益比还需进一步研究。

这项横断面研究共纳入46家医院31个月内新诊糖尿病患者17349例,平均年龄52.6岁,男性占15.3%。其中1型糖尿病包括经典1型糖尿病和LADA,后者均经检测谷氨酸脱羧酶自身抗体确诊。

原始出处:
Tang X, Yan X, Zhou H, et al. Prevalence and identification of type 1 diabetes in Chinese adults with newly diagnosed diabetes. Diabetes Metab Syndr Obes. 2019 Aug 28;12:1527-1541.

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    2020-04-17 一闲
  5. [GetPortalCommentsPageByObjectIdResponse(id=1639259, encodeId=dbd8163925963, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Sat Jan 18 10:31:00 CST 2020, time=2020-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1761235, encodeId=e0eb1e6123570, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Sun Dec 08 13:31:00 CST 2019, time=2019-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1902346, encodeId=b634190234655, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0045169, createdName=木头人513, createdTime=Mon Oct 12 20:31:00 CST 2020, time=2020-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1896578, encodeId=b70b18965e8c5, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Fri Apr 17 12:31:00 CST 2020, time=2020-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1888089, encodeId=b913188808915, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Wed Jun 10 07:31:00 CST 2020, time=2020-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=375291, encodeId=5e1b3e52916c, content=学习了,不错的话题,非常精彩,受益非浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7b005228115, createdName=14794e5bm67(暂无昵称), createdTime=Fri Nov 15 18:37:25 CST 2019, time=2019-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1042816, encodeId=b9241042816eb, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Thu Nov 14 01:31:00 CST 2019, time=2019-11-14, status=1, ipAttribution=)]
    2020-06-10 guojianrong
  6. [GetPortalCommentsPageByObjectIdResponse(id=1639259, encodeId=dbd8163925963, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Sat Jan 18 10:31:00 CST 2020, time=2020-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1761235, encodeId=e0eb1e6123570, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Sun Dec 08 13:31:00 CST 2019, time=2019-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1902346, encodeId=b634190234655, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0045169, createdName=木头人513, createdTime=Mon Oct 12 20:31:00 CST 2020, time=2020-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1896578, encodeId=b70b18965e8c5, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Fri Apr 17 12:31:00 CST 2020, time=2020-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1888089, encodeId=b913188808915, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Wed Jun 10 07:31:00 CST 2020, time=2020-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=375291, encodeId=5e1b3e52916c, content=学习了,不错的话题,非常精彩,受益非浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7b005228115, createdName=14794e5bm67(暂无昵称), createdTime=Fri Nov 15 18:37:25 CST 2019, time=2019-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1042816, encodeId=b9241042816eb, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Thu Nov 14 01:31:00 CST 2019, time=2019-11-14, status=1, ipAttribution=)]
    2019-11-15 14794e5bm67(暂无昵称)

    学习了,不错的话题,非常精彩,受益非浅

    0

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    2019-11-14 misszhang

    谢谢MedSci提供最新的资讯

    0

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