识别和研究成人1型糖尿病的挑战
Nicholas J Thomas1,2, Angus G Jones3,4
1Department of Clinical and Biological Sciences, University of Exeter, Exeter, UK.
Diabetologia
|September 20, 2023
概括
诊断成人发病的1型糖尿病是具有挑战性的,因为错误的分类与2型糖尿病. 高特异性测试揭示了1型糖尿病的特征在成年年龄之间是一致的.
科学领域:
- 内分泌学和新陈代谢学
- 免疫学 免疫学 免疫学
- 糖尿病研究 糖尿病研究
背景情况:
- 成人1型糖尿病 (T1D) 诊断往往因其与2型糖尿病 (T2D) 的相似性而复杂,特别是在老年人中.
- 对成人T1D的错误分类可能导致患者管理不足,并对T1D队列的研究结果产生偏差.
- 根据年龄对T1D特征的现有研究差异可能来自混合人群,包括非自身免疫性糖尿病.
研究的目的:
- 为了解决成人发病型1型糖尿病的诊断挑战.
- 为了澄清T1D的临床表现,免疫学标志物和成人T1D的进展,不论发病时的年龄.
- 为在临床实践和研究环境中准确识别自身免疫性糖尿病提供建议.
主要方法:
- 对成人T1D患者的临床表现,小岛自身抗体状况,遗传倾向和C-水平的分析.
- 应用高特异性的诊断方法来区分自身免疫 (T1D) 与其他形式的糖尿病.
- 评估目前关于在怀疑T1D和T2D背景下进行小岛自身抗体测试的临床指南.
主要成果:
- 在使用高特异性标准诊断时,成年T1D显示一致的临床特征,小岛自身抗体阳性,遗传背景和C-衰减在所有成年年龄段.
- 对于高度怀疑T1D或在T2D诊断后迅速进展的个人,建议进行例行岛屿自身抗体检测.
- 在低患病率的T2D人群中,广泛的岛屿自身抗体查产生了对自身免疫糖尿病的适度积极预测值.
结论:
- 成人发病的1型糖尿病的临床表型在很大程度上独立于年龄,当使用特定的诊断方法准确地确定时.
- 高特异性的诊断策略对于了解晚发性自身免疫糖尿病的真正特征至关重要.
- 采用精确的诊断方法是必要的,以克服在研究和实践中对成年T1D表型的持续误解.
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