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目的探讨衡阳地区初诊2型糖尿病(T2DM)患者中成人隐匿性自身免疫性糖尿病(LADA)的患病率及其临床特征。方法对102例病程1年以内非酮症起病的初诊T2DM患者采用放射配体法检测谷氨酸脱羧酶抗体(GADA),同时测量身高、体重、体质指数(BMI)、血压,检测空腹血糖、空腹C肽(FCP)、糖化血红蛋白(HbA1c)、血脂、超敏促甲状腺激素(uTSH)、甲状腺球蛋白抗体(TG-Ab)与甲状腺过氧化物酶抗体(TPOAb),比较GADA阳性患者与GADA阴性患者之间的临床特征与生化特征差异。结果初诊T2DM患者GADA阳性率即LADA患病率为9.8%(10/102);与GADA阴性患者比较,GADA阳性LADA患者BMI较小,空腹C肽水平较低,uTSH异常检出率与TPOAb阳性率增高(均P<0.05)。结论衡阳地区初诊2型糖尿病患者中存在一定比例的LADA患者;对于BMI较小、胰岛功能较差的初发T2DM患者应及早检测GADA。
Objective To investigate the prevalence and clinical features of latent autoimmune diabetes (LADA) in adults with newly diagnosed type 2 diabetes mellitus (DM) in Hengyang district. Methods Twenty-two newly diagnosed T2DM patients with non-ketosis onset within 1 year were tested for GADA by radioligand method. Meanwhile, height, weight, body mass index (BMI), blood pressure and fasting plasma glucose , Fasting C-peptide (FCP), HbA1c, lipids, uTSH, TG-Ab and thyroid peroxidase antibody (TPOAb) Differences in clinical features and biochemical features between GADA-negative patients. Results The prevalence of GADA in newly diagnosed T2DM patients was 9.8% (10/102). Compared with GADA-negative patients, GADA-positive LADA patients had lower BMI and lower fasting C-peptide levels, and the positive rate of uTSH was higher than that of TPOAb Rate increased (all P <0.05). Conclusion There is a certain proportion of patients with LADA in newly diagnosed type 2 diabetic patients in Hengyang district and GADA in newly diagnosed T2DM patients with small BMI and poor islet function as early as possible.