·胰岛素抵抗及其相关疾病·

　　【摘要】 目的 对酮症起病的T2DM患者的临床特征进行分析，探讨酮症倾向的T2DM的发病机制。 方法 收集新诊断的T2DM患者167例，其中以酮症起病T2DM患者(KPD组)76例，无酮症的T2DM者(T2DM组)91例,比较两组治疗前的BMI，随机血糖(PG)、TG、HbA1c、FC-P、胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)之间的差异。 结果 KPD组超重及肥胖患者比例、随机PG、HbA1c、TG水平、HOMA-IR指数均高于T2DM组(P<0.005或P<0.001)，FC-P水平、HOMA-β指数低于T2DM组(P<0.001)。但治疗后两组患者FC-P水平，比较差异无统计学意义。 结论 酮症倾向的T2DM发病原因可能与更高水平的PG、TG、肥胖及与之伴随的慢性炎症有关。

　　【关键词】 糖尿病，2型;酮症;血糖;甘油三酯;胰岛β细胞;胰岛素抵抗

To investigate clinical characteristics of newly­diagnosed ketosis-prone diabetic (KPD) patients SHI Wan-chun,QIU Wei,WANG Wen-hua,et al.Department of Endocrinology,Huzhou Central Hospital,Huzhou313000,China

　　【Abstract】 Objective To analyse the clinical characteristics and explore mechanism of newly­diagnosed ketosis-prone diabetic (KPD) patients. Methods 167 KPD patients were devided into 76 patients with ketosis­onset(KPD group) and 91 patients without ketosis(T2DM group) to evaluate the difference in BMI,random plasma glucose,TG,HbA1c,fasting C-peptide,islet β cell function index (HOMA-β) and insulin resistance index (HOMA-IR) before treatment. Results Compared with T2DM group,KPD group showed that the incidence of overweight and obesity,random plasma glucose,TG, HbA1c,HOMA-IR were significantly higher(P<0.005 or P<0.001),but the levels of fasting C-peptide and HOMA-β were significantly lower(P<0.001).The level of fasting C-peptide was not significantly different between two groups after treatment. Conclusion The mechanism of KPDmay relate to the high levels of plasma glucose and TG，obesity and chronic inflammation correlating with obesity.

　　【Key words】 Diabetes mellitus,type 2;Ketosis-prone;Plasma glucose; Triglyceride;Islet β cell;Insulin resistance