Yang Daizhi, Deng Hongrong, Luo Guochun, Wu Ge, Lin Shaoda, Yuan Lin, Xv Meilun, Li Shaoqing, Zhang Xiuwei, Wu Jianneng, Lang Jiangming, Liang Ganxiong, Lin Jiancai, Chen Dingyu, Li Lu, Fang Yishan, Wu Yongxin, Ou Wenxin, Li Jin, Weng Jianping, Yan Jinhua
Department of Endocrinology & Metabolic Disease, The 3rd Affiliated Hospital of Sun Yat-sen University.
Guangdong Diabetes Center, Guangzhou.
J Diabetes. 2016 Nov;8(6):847-853. doi: 10.1111/1753-0407.12366. Epub 2016 Mar 6.
A lack of demographic and clinical data hinders efforts of health care providers in China to support patients with type 1 diabetes mellitus (T1D). Therefore, the aim of the present retrospective study was to provide an overview of the demographic and clinical characteristics of Chinese patients with T1D.
Hospital medical records of patients with T1D (diagnosed between January 2000 and December 2011) in 105 secondary and tertiary hospitals across Guangdong province were reviewed. Data were collected on patient age at diagnosis, presentations at onset, physical examination, and diabetes management.
In all, 3173 patients diagnosed with T1D between January 2000 and December 2011 were included in the study (46.2% female). The median age at diagnosis was 27.5 years (interquartile range [IQR] 18.0-38.0) years and the median body mass index (BMI) at onset was 19.6 kg/m (IQR 17.4-21.8 kg/m ). Among adult patients, 0.9% were obese, 6.6% were overweight, 62.3% were normal weight, and 30.3 % were underweight. The prevalence of diabetic ketoacidosis (DKA) at onset was 50.1%. The proportion of patients with retinopathy, nephropathy, and neuropathy was 8.1%, 20.7 %, and 11.1%, respectively.
The adult-onset form of T1D is not rare in China. The registry participants were characterized by older age at onset, lower BMI, and a higher prevalence of DKA at onset compared with those in regions with a high incidence of T1D, such as northern Europe. These findings contribute to a better understanding of the heterogeneity of T1D in different populations and so will help healthcare providers to develop management models that are more suitable for these patients.
缺乏人口统计学和临床数据阻碍了中国医疗保健提供者为1型糖尿病(T1D)患者提供支持的努力。因此,本回顾性研究的目的是概述中国T1D患者的人口统计学和临床特征。
回顾了广东省105家二级和三级医院中T1D患者(2000年1月至2011年12月确诊)的医院病历。收集了患者诊断时的年龄、发病表现、体格检查和糖尿病管理方面的数据。
本研究共纳入了2000年1月至2011年12月期间确诊为T1D的3173例患者(46.2%为女性)。诊断时的中位年龄为27.5岁(四分位间距[IQR]为18.0 - 38.0岁),发病时的中位体重指数(BMI)为19.6 kg/m²(IQR为17.4 - 21.8 kg/m²)。在成年患者中,0.9%为肥胖,6.6%为超重,62.3%体重正常,30.3%体重过轻。发病时糖尿病酮症酸中毒(DKA)的患病率为50.1%。视网膜病变、肾病和神经病变患者的比例分别为8.1%、20.7%和11.1%。
在中国,成人发病型T1D并不罕见。与T1D高发地区(如北欧)的患者相比,本登记研究的参与者发病年龄较大、BMI较低且发病时DKA患病率较高。这些发现有助于更好地理解不同人群中T1D的异质性,从而有助于医疗保健提供者制定更适合这些患者的管理模式。