CAJ | 학술논문

目的探讨酮症倾向糖尿病(KPD)患者临床特征、自身抗体检出情况及胰岛β细胞功能.方法检测78例KPD患者血清谷氨酸脱羧酶抗体(GAD-Ab)、胰岛细胞抗体(ICA)、胰岛素自身抗体(IAA)、C-P.任一抗体阳性为A+,3种抗体均阴性为A-,空腹FC-P≥0.333nmol/L为β+,反之为β-.根据结果78例KPD患者分4组:A+β+;A+β-;A-β+;A-β-.比较各组的临床特征、自身抗体及胰岛功能.结果 A-β+组发病年龄最大,BMI、合并高血压和肥胖的百分率、TG、TC、FC-P和餐后C-P较高;A+β-组发病年龄最轻,BMI、合并高血压和肥胖的百分率、C-P水平最低;A+β+组和A-β-组临床特征介于A+β-组和A-β-组之间.结论 KPD临床特点不同,自身免疫抗体和胰岛β细胞功能差异显著,提示应根据不同临床特点采取不同的治疗.
목적 탐토동증경향당뇨병(KPD)환자림상특정、자신항체검출정황급이도β세포공능.방법 검측78례KPD환자혈청곡안산탈최매항체(GAD-Ab)、이도세포항체(ICA)、 이도소자신항체(IAA)、C-P.임일항체양성위A+,3충항체균음성위A-,공복FC-P≥0.333nmol/L위β+,반지위β-.근거결과78례KPD환자분4조:A+β+;A+β-;A-β+;A-β-.비교각조적림상특정、자신항체급이도공능.결과 A-β+조발병년령최대,BMI、합병고혈압화비반적백분솔、TG、TC、FC-P화찬후C-P교고;A+β-조발병년령최경,BMI、합병고혈압화비반적백분솔、C-P수평최저;A+β+조화A-β-조림상특정개우A+β-조화A-β-조지간.결론 KPD림상특점불동,자신면역항체화이도β세포공능차이현저,제시응근거불동림상특점채취불동적치료.
Objective To investigate the clinical characteristics of islet auto-antibodies and β-cell function in patients with ketosis-prone diabetes(KPD). Methods A total of 78 patients with KPD were divided into four categorical groups based on the presence or absence of auto-antibodies (A+ or A-) and of β-cell functional reserve(β+ β-):A+β+(group 1,n=13),A-β-(group 2,n=18),A-β+(group 3,n=28),A+β-(group 4,n=19).Islet auto-antibodies,including glutamic acid decarboxylase antibody(GAD-Ab),islet cell antibody(ICA)and insulin autoantibody(IAA) were measured. The clinical characteristics,biochemical parameters and serum peptide were compared among four groups. Results Compared with group 1,2 and 4,group 3 showed the oldest age at onset,and higher levels of BMI,hypertension,serum triglyceride,cholesterol,fasting and postprandial C-peptide. Patients in group 2 had the youngest age at onset,the lowest level of serum C peptide. The phenotypes of patients in group 1 and group 4 were intermediate between group 2 and group 3. Conclusions About 39.7% of patients with KPD have positive islet auto-antibodies. Patients with KPD show significantly different levels of β-cell function,clinical characteristics and biochemical parameters,which may need different therapeutic strategies