Clinical, biochemical, and immunological characteristics of newly diagnosed nonobese diabetic patients aged 18–45 years in China
Introduction
Diabetes mellitus affected over 200 million people worldwide in 2003, and the number is projected to be 360 million by 2030 (Wild et al., 2004). In China, diabetes has become epidemic due to lifestyle westernization and physical inactivity.
Type 1 and type 2 diabetes mellitus (T1DM and T2DM) are the two most common forms of diabetes mellitus. In clinical practice, however, we often see patients who exhibit clinical presentations of both T1DM and T2DM. These patients cannot distinctly be allocated to either T1DM or T2DM and thus are referred to be in “a grey area.” Latent autoimmune diabetes in adults (LADA) has been shown to be in this grey area characterized by clinical features between T1DM and T2DM (Groop et al., 2006). The United Kingdom Prospective Diabetes Study showed that LADA accounted for about 10% of all adult-onset T2DM (Turner et al., 1997), and the percentage of autoimmune diabetes is likely higher among those nonobese diabetic patients. In China, there are more lean diabetic patients compared with Western countries. The aim of this study is to characterize the clinical, biochemical, and immunological features of the recent-onset nonobese diabetic patients aged 18–45 years in Peking Union Medical College Hospital from 2007 to 2009.
Section snippets
Study population
One hundred and three newly diagnosed (duration less than 3 months) diabetes patients aged 18–45 years old with body mass index (BMI)<23 kg/m2 were referred to the Department of Endocrinology at Peking Union Medical College Hospital from January 2007 to April 2009. Through careful clinical examination and follow-up, 70 of them were diagnosed as having T1DM, 21 had T2DM, 11 had LADA, and 1 had mitochondrial diabetes. The diagnosis of diabetes was made according to the guidelines of the American
The proportion of various types of diabetes of the study population and their general characteristics
Excluding one mitochondrial diabetes patient, there were 102 diabetic patients enrolled in this study. The percentage of T1DM was 68.6%, that of T2DM was 20.6%, and 11 (10.8%) patients met the diagnosis criteria of LADA. The mean age of onset of T1DM patients was (24.8±6.6 years) younger than that of T2DM (34.8±7.5 years) and LADA (42.2±5.1 years) patients (P<.01). Diabetes family history was more common in T2DM (70.6%) than in T1DM (27.4%) and LADA (28.6%) (P<.01). The mean blood pressure of
Discussion
This study reported the prevalence of autoimmune diabetes in lean adult-onset diabetic patients and characterized their clinical and biochemical profiles as well as autoimmune features. In general, overweight is defined as BMI≥25 kg/m2 in Western populations. However, we used BMI≥23 kg/m2 as a cutoff to define overweight in the study sample because previous studies have indicated that Asians tend to have obesity-related illnesses, e.g., diabetes and cardiovascular diseases, with lower BMI (Wen
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Tianjin Metabolic Disease Hospital, Tianjin Medical University, Key Laboratory of Hormone and Development, Ministry of Health, Tianjin 300070, China.