2003-2010年非高加索人群因糖尿病入院的影响和特点

Patricia San José, Mireia Guerrero, Isabel García-Martín, Jordi Caballero, Manuel Pérez-Maraver
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摘要

目的评估2003-2010年期间因症状性糖尿病入院的非高加索患者的患病率,并分析他们在诊断时和2年后与高加索人群的差异特征。材料和方法回顾性观察研究。纳入标准:2003年1月至2010年10月因新发症状性糖尿病入院的18-40岁患者。分析了非高加索血统患者的患病率,并在诊断时和2年后比较了两个人群的临床、生化、免疫和β细胞功能。结果因新发症状性糖尿病入院的患者中,19%为非白种人,近年来呈逐渐增加趋势。非高加索患者的失代偿较轻(3.0%患有酮症酸中毒,而高加索组为15.2%,p<0.05),自身免疫较低(27.2 vs.73.1%,p<0.01),刺激的C肽水平较高(0.70±0.56 vs.0.42±0.39 nmol/L,p>0.05),主要是因为自身免疫阴性的亚组(0.82 vs.0.25)。诊断两年后,接受强化治疗的非高加索患者较少(39.1%对93.8%)。结论非高加索患者自身免疫发生率较低,诊断时β细胞功能较好,特别是由于自身免疫阴性的亚组,诊断后2年不需要强化治疗,这些特征更具2型糖尿病的特征。
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Impact and characteristics of the non-Caucasian population in hospital admissions for diabetes onset during 2003–2010

Aims

To assess the prevalence of non-Caucasian patients in hospital admissions for onset of symptomatic diabetes mellitus during the 2003–2010 period, and to analyze the characteristics differentiating them from the Caucasian population at diagnosis and 2 years later.

Material and methods

A retrospective, observational study. Inclusion criteria: patients aged 18–40 years admitted for de novo symptomatic diabetes from January 2003 to October 2010. Prevalence of patients of non-Caucasian origin was analyzed, and clinical, biochemical, immunological, and beta-cell function of both populations were compared at diagnosis and 2 years later.

Results

Nineteen percent of patients admitted to hospital for de novo symptomatic diabetes were non-Caucasian, with a progressive increase in recent years. Non-Caucasian patients had milder decompensation (3.0% had ketoacidosis, as compared to 15.2% in the Caucasian group, p < 0.05), lower presence of autoimmunity (27.2 vs. 73.1%, p < 0.01) and higher stimulated C-peptide levels (0.70 ± 0.56 vs. 0.42 ± 0.39 nmol/L, p < 0.05), mainly because of the subgroup with negative autoimmunity (0.82 vs. 0.25). Two years after diagnosis, less non-Caucasian patients were on intensified treatment (39.1 vs. 93.8%).

Conclusions

Non-Caucasian patients had a lower prevalence of autoimmunity, better beta-cell function at diagnosis, particularly due to the subgroup with negative autoimmunity, and less need for intensive treatment 2 years after diagnosis, features which are more characteristic of type 2 diabetes mellitus.

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