患有B型胰岛素抗性的患者的风湿学表现
S Amara Ogbonnaya1, Sandra G Williams1, Raphael A Kirou1
1National Institute of Arthritis and Musculoskeletal and Skin Diseases, 9000 Rockville Pike, Building 10 10N311, Bethesda, Maryland, 20894, United States.
Arthritis care & research
|February 18, 2026
概括
B型胰岛素耐药性 (TBIR),系统性红斑狼 (SLE) 的罕见并发症,与高U1RNP自身抗体有关. 早期识别和治疗对于这种危及生命的疾病至关重要.
科学领域:
- 内分泌学 在内分泌学.
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
背景情况:
- B型胰岛素抵抗 (TBIR) 是一种自身免疫性疾病,由抑制胰岛素受体的自身抗体引起.
- 它经常表现为严重的高血糖症,体重减轻和尼格里卡斯白病,需要密集的胰岛素治疗,并且在没有治疗的情况下死亡率很高.
- TBIR经常与全身性红斑狼 (SLE) 相关.
研究的目的:
- 确定与患者TBIR相关的临床和实验室特征.
- 提高对TBIR作为一种罕见但危及生命的疾病的认识,通常与SLE有关.
主要方法:
- 在国家卫生研究院 (1976-2024) 观察到的38名TBIR患者的回顾性图表审查.
- 分析包括初级风湿学诊断,内分泌学实验室测量和SLE表现 (低补充血,细胞衰竭,自身抗体).
主要成果:
- 系统性红斑狼 (SLE) 是最常见的基本诊断 (81.5%).
- 患者主要是女性 (89.5%) 和黑人/非洲裔美国人 (84.2%), SLEDAI-2K 中位数为14.
- 在50%以上的患者中存在高位U1RNP自身抗体. 与此相关的疾病包括神经神经病变 (18.4%),血管 (10.5%),脑膜炎 (5%).
结论:
- B型胰岛素耐药性 (TBIR) 是一种罕见但严重的SLE并发症.
- 高位数的U1RNP自身抗体与SLE患者的TBIR有关.
- 创伤性心脏损伤可能与其他罕见的SLE表现同时发生,强调需要对患者进行全面评估.
相关概念视频
Insulin: Dosing Regimen and Adverse Effects
874
Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
874
Diabetes Mellitus: Overview and Type I Subtype
5.6K
Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
5.6K
Diabetes Mellitus: Type 2 and Gestational
5.1K
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
5.1K
Diabetes: Symptoms, Diagnosis, and Complications
2.4K
For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
2.4K
Oral Hypoglycemic Agents: Biguanides and Glitazones
702
Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood...
702
Carbohydrate Metabolism
14.5K
Carbohydrates are polymers composed of molecules containing atoms of carbon, hydrogen and oxygen. One gram of carbohydrate can provide four kilo-calories of energy, which makes it the most efficient instant energy source.
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...
14.5K


