在尼日利亚北部三级医疗机构就诊的2型糖尿病患者中,成人潜伏性自身免疫性糖尿病(LADA)亚组的代谢谱模式

S. Muazu, I. Okpe, F. Anumah, A. Bakari
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A fasting blood test was taken for glucose, lipids, HbA1c, c-peptide, and glutamic acid decarboxylase antibody (GADA) estimation. ELISA method (Kronus kit, USA) was used for GADA estimation, >5.0 units/ml was considered positive while c-peptide value of < 1.0 μ/ml is considered low. A clinical criterion for the diagnosis of LADA was used. The Modified International Diabetes Federation-ethnic criteria for classification of MS were used. The SPSS package version 20 was used to analyze the data with P < 0.05 as statistically significant level. Results: The mean ages for LADA and T2DM were 50.1 (11.3) and 51.2 (9.1) years, respectively, and the mean duration of disease was 6.1 (3.7) years in LADA and 7.0 (5.6) years in T2DM patients, P> 0.05. The BMI and WC were 22.1 (5.1) and 80.1 (12.4) cm for LADA and 27.3 (4.9) and 93.2 (10.9) cm for T2DM patients, respectively, P < 0.05. 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引用次数: 1

摘要

目的:胰岛素分泌缺陷,而不是抵抗,是成人潜伏性自身免疫性糖尿病(LADAs)的共同特征,胰岛素抵抗被认为是代谢综合征(MS)病理生理学的核心。该研究的目的是描述尼日利亚北部LADA的临床和心脏代谢特征的模式。方法:对年龄和性别匹配的48例LADA患者、50例2型糖尿病(T2DM)患者和52例正常对照进行横断面调查。临床和身体特征包括体重、身高、腰围、臀围和血压测量。身体质量指数(BMI)和腰臀比也被测定。空腹血检查葡萄糖、血脂、糖化血红蛋白、c肽和谷氨酸脱羧酶抗体(GADA)的估计。采用ELISA法(美国Kronus试剂盒)进行GADA测定,≥5.0单位/ml为阳性,< 1.0 μ/ml为低值。采用一种诊断LADA的临床标准。采用改良的国际糖尿病联合会-种族标准对多发性硬化症进行分类。采用SPSS软件包第20版对数据进行分析,以P < 0.05为统计学显著水平。结果:LADA和T2DM患者的平均年龄分别为50.1(11.3)岁和51.2(9.1)岁,平均病程分别为6.1(3.7)年和7.0(5.6)年,P> 0.05。LADA组BMI、WC分别为22.1(5.1)、80.1 (12.4)cm, T2DM组BMI、WC分别为27.3(4.9)、93.2 (10.9)cm, P < 0.05。LADA显示高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TGD)和血压值较低,而T2DM组血糖控制较好。正常组、LADA组和T2DM组MS患病率分别为5.7%、19%和68%。结论:本研究发现,LADA糖尿病亚群表现出与胰岛素分泌缺陷和胰岛素抵抗一致的代谢特征。研究发现,这些人身材苗条,TGD和HDL-C水平较低。
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Pattern of metabolic profile of latent autoimmune diabetes in adults (LADA) subgroup among type two diabetic patients attending tertiary health facility in Northern Nigeria
Aims: Insulin secretory defect, but not resistance, is the common feature of latent autoimmune diabetes in adults (LADAs), and insulin resistance is considered central in the pathophysiology of metabolic syndrome (MS). The aim of the study is to describe the pattern of the clinical and cardiometabolic characteristics of LADA in Northern Nigeria. Methods: This cross-sectional survey was conducted involving age- and sex-matched 48 LADA patients, 50 type 2 diabetes mellitus (T2DM) patients, and 52 normal controls,. The clinical and physical characteristics including weight, height, waist circumference, hip circumference, and blood pressure measurements were performed. The body mass index (BMI) and waist–hip ratio were also determined. A fasting blood test was taken for glucose, lipids, HbA1c, c-peptide, and glutamic acid decarboxylase antibody (GADA) estimation. ELISA method (Kronus kit, USA) was used for GADA estimation, >5.0 units/ml was considered positive while c-peptide value of < 1.0 μ/ml is considered low. A clinical criterion for the diagnosis of LADA was used. The Modified International Diabetes Federation-ethnic criteria for classification of MS were used. The SPSS package version 20 was used to analyze the data with P < 0.05 as statistically significant level. Results: The mean ages for LADA and T2DM were 50.1 (11.3) and 51.2 (9.1) years, respectively, and the mean duration of disease was 6.1 (3.7) years in LADA and 7.0 (5.6) years in T2DM patients, P> 0.05. The BMI and WC were 22.1 (5.1) and 80.1 (12.4) cm for LADA and 27.3 (4.9) and 93.2 (10.9) cm for T2DM patients, respectively, P < 0.05. The LADA showed lower high-density lipoprotein-cholesterol (HDL-C), triglyceride (TGD), and blood pressure values, while the T2DM group had a better glucose control. The prevalence of MS was 5.7%, 19%, and 68% for the normal, LADA, and T2DM groups, respectively. Conclusions: It was found in this study that LADA subset of diabetes exhibited metabolic features consistent with both defective insulin secretion and insulin resistance. They were found to be lean with low TGD and HDL-C levels.
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