1型糖尿病的性别差异:一个被低估的疾病维度

IF 2.4 Q3 ENDOCRINOLOGY & METABOLISM Diabetology Pub Date : 2022-06-20 DOI:10.3390/diabetology3020027
P. Tatti, Singh Pavandeep
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引用次数: 3

摘要

近年来,性别差异在医学和生物学的各个领域都成为人们非常感兴趣的话题。目前,大多数研究在二次分析中报告了性别差异;然而,这些信息很少得到临床医生的关注,而且常常被媒体大肆宣扬的总体主要积极结果所淹没。此外,更重要的是,在对研究主题的研究中,如果没有具体和仔细的计划,任何对结果的统计评估都可能是毫无价值的。在动物身上的研究很少,但这些研究通常不是有用的,因为与人类相比,动物的生物学、药效学和药代动力学不同。1型糖尿病是一种很容易评估性别差异的疾病。不管胰腺β细胞功能丧失的原因是什么,所有形式的1型糖尿病的共同点是缺乏循环胰岛素和外周胰岛素敏感性降低,导致需要外源性注射。因此,外源性胰岛素输注,与任何广泛使用的研究工具,如胰岛素-葡萄糖钳,可以很容易地用于评估性别差异。女性1型糖尿病患者影响血糖水平的因素有很多。例如,驱动排卵/月经周期的激素以及更年期时相关的变化对胰岛素的作用有影响;因此,人们应该期待这方面的研究重点。相反,缺乏关于这一主题的可用数据,并且没有泵生产商创建了针对性别的胰岛素输注概况。通常是根据病人的诊断来接近他们。根据现代思维方式,本综述旨在关注个性化治疗,更具体地说是性别治疗。
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Gender Difference in Type 1 Diabetes: An Underevaluated Dimension of the Disease
Gender difference in all fields of medicine and biology has recently become a topic of great interest. At present, most studies report gender differences in their secondary analysis; however, this information receives scant attention from clinicians, and is often overwhelmed by press trumpeting the overall main positive results. Furthermore, and more importantly, any statistical evaluation of results obtained without specific and careful planning in the study for the topic of research is probably worthless. There are few studies in animals, but these are not typically useful because of the different biology, pharmacodynamics and pharmacokinetics compared to humans. Type 1 diabetes is a disease where gender difference can be easily evaluated. Irrespective of the cause of the loss of pancreatic beta-cell function, the common denominators of all forms of type 1 diabetes are the absence of circulating insulin and a reduction in peripheral insulin sensitivity leading to exogenous injections being required. Consequently, exogenous insulin infusion, with any of the widely used research tools, such as the insulin–glucose clamp, can be easily used to evaluate gender difference. Female patients with type 1 diabetes have many factors that impact glucose level. For example, the hormones that drive the ovulatory/menstrual cycle and the connected change at the time of the menopause have a role on insulin action; thus, one should expect great research emphasis on this. On the contrary, there is a dearth of data available on this topic, and no pump producer has created a gender-specific insulin infusion profile. Patients are usually approached on the basis of their diagnosis. This review is intended to focus on personalized treatment, more specifically on gender, according to the modern way of thinking.
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