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目的 比较成人隐匿性自身免疫性糖尿病 (LADA)与 2型糖尿病患者临床特点、大血管病变危险因素及微血管病变的患病情况。方法 以 1∶2病例对照、横断面研究 30例LADA患者与 60例 2型糖尿病患者大血管病变危险因素及微血管病变的患病情况。结果 LADA患者体重指数较 2型糖尿病患者低 (2 1 3± 0 5对 2 3 3± 0 4kg/m2 ,P <0 0 1) ,空腹及餐后 2hC肽水平较后者低 (分别为 0 4 6± 0 0 4对 0 68± 0 0 6nmol/L ,P <0 0 5 ;0 87± 0 0 7对 1 15± 0 0 9nmol/L ,P <0 0 5 ) ,较短的磺脲类降糖药有效治疗时间 (2 0± 0 2对 3 9± 0 2年 ,P <0 0 5 ) ,较高的磺脲类降糖药继发失效的例数 (8/30对 5 /60 ,P <0 0 5 ) ,较低的腰 /臀比值 (WHR) (0 81± 0 0 1对0 86± 0 0 1,P <0 0 5 ) ,较少的中心性肥胖例数 (5 /30对 2 4 /60 ,P <0 0 5 ) ,较少的合并高血压的例数 (12 /30对4 2 /60 ,P <0 0 1)。微血管病变 (视网膜病变、肾病 )的患病情况在两组间无显著性差异。Logistic回归分析显示病程与HbA1c是糖尿病视网膜病变的显著影响因素 ;而有无高血压 ,有无糖尿病家族史 ,ICA阳性则被回归分析忽略。结论 LADA与 2型糖尿病临床比较 ,前者病人较瘦 ,C肽水平较低 ,磺脲类降糖药较易失效 ,而且
Objective To compare the clinical features of adults with latent autoimmune diabetes (LADA) and type 2 diabetes mellitus, the risk factors of macrovascular complications and the prevalence of microangiopathy. Methods The prevalence of macrovascular disease and microangiopathy in 30 patients with LADA and 60 patients with type 2 diabetes mellitus were studied by 1: 2 case-control. Results The body mass index of LADA patients was lower than that of type 2 diabetes patients (21 3 ± 0 5 vs 23 3 ± 0 4 kg / m 2, P 0 01) and lower fasting and postprandial 2-hour C peptide levels (0 4 6 ± 0 0 4 versus 0 68 ± 0 0 6 nmol / L, P 0 05; 0 87 ± 0 0 7 vs 1 15 ± 0 0 9 nmol / L, P 0 05), shorter sulfonylureas The effective treatment time of hypoglycemic agents (20 ± 0 2 vs 39 ± 0 2 years, P <0 05), the higher number of cases of secondary failure of sulfonylurea hypoglycemic agents (8/30 vs 5 / 60, P <0.05), lower WHR (0 81 ± 0 0 1 versus 0 86 ± 0 0 1, P 0 05), fewer cases of central obesity 5/30 vs 24/60, P <0.05), with fewer cases of combined hypertension (12/30 vs. 42/60, P <0.01). The prevalence of microangiopathy (retinopathy, nephropathy) was not significantly different between the two groups. Logistic regression analysis showed that the course of disease and HbA1c were the significant influencing factors of diabetic retinopathy. Whether there was hypertension, family history of diabetes or ICA positive was neglected by regression analysis. Conclusion LADA and type 2 diabetes clinical comparison, the former patients are lean, C-peptide level is low, sulfonylurea drugs more likely to failure, and