成人隐匿性自身免疫性糖尿病1.ppt

latent autoimmune diabetesin adults (LADA) 内分泌科 马慧娟 内容与目的 一篇文章:小问题也能出大文章 一个诊断:LADA的诊治现状 一个猜想:现在与未来糖尿病分型展望 Diabetes Research and Clinical Practice 77 (2007)  Equivalent insulin resistance in latent autoimmune diabetesin adults (LADA) and type 2 diabetic patients Background LADA characterized that indicate an autoimmune attack on the pancreatic beta cells and insulin resistance Previous studies have suggested that insulin resistance in LADA is lower relative to T2DM, and perhaps more comparable to the insulin resistance noted in type 1 diabetes (T1DM) ？whether this might be related to differences in body mass index (BMI) has not been excluded. Methods A type 2 diabetic phenotype required the onset of diabetes (de?ned by a fasting plasma glucose ? 126 mg/dL or symptoms of diabetes with a random plasma glucose ? 200 mg/dL, within 5 years of diagnosis.) between ages 35 and 70 years, no history of ketonuria or ketoacidosis, and the absence of a need for insulin in the initial 6 months after diagnosis. within 5 years of diagnosis ，A1c between 6%and 10% Exclusion criteria included: a history of chronic pancreatitis or other secondary cause of diabetes; treatment with systemic corticosteroids; concurrent severe systemic illness (such as recentmyocardial infarction, congestive heart failure, or cerebral vascular disease); renal insuf?ciency ; or hepatic dysfunction Non-diabetic controls ：150 subjects Statistical analysis Data were analyzed primarily with Stata/SE 8.2 . Due to skewed distributions, natural log-transformed insulin, BMI, and HOMA-IR values 测定指标 glutamic acid decarboxylase autoantibodies（GADA）, autoantibodies to the tyrosine phosphatase IA-2(IA-2A), islet cell autoantibodies (ICA), and insulin autoantibodies (IAA treated with Insulin were not ） HOMA-IR Autoantibody status of the LADA patients Results Insulin resistance as a function of BMI as assessed by HOMA-IR in non-diabetic controls, LADA, and T2DM Characteristics of the male study subjects Di