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目的:了解40岁以下发病的糖尿病患者的临床特点以及胰淀素(IAPP)Ser20Gly突变在该人群的发生情况.方法:常规方法测定234例40岁以下发病糖尿病患者的糖脂代谢、GAD抗体、胰岛素抵抗,分析其家族史和治疗情况并用PCR-RFLP和直接序列分析方法对IAPPSer20Gly突变情况进行筛查.结果:糖尿病患者的FBG,PBG2h明显高于正常人(P<0.001),TG增高(P<0.05),平均HbA1c(10.4±2.4)%,HOMAIR 3.63~8.60.GAD-Ab阳性者占3.42%.有糖尿病家族史者占61.54%.饮食、运动疗法和口服药物治疗者分别占40.6%,41.03%,而胰岛素治疗者有18.65%.在234例糖尿病患者中发现2例IAPP基因Ser20Gly突变者,其中1例为纯合子,另1例为杂合子突变.结论:40岁以下发病糖尿病患者存在明显代谢异常和胰岛素抵抗.IAPP Ser20Gly突变在该人群发生率约为0.85%.
Objective: To investigate the clinical features of diabetes mellitus patients under 40 years of age and the occurrence of Ser20Gly mutation of amylin (IAPP) in this population.Methods: 234 patients with diabetes under 40 years of age were assayed for glucose and lipid metabolism, GAD antibody, Insulin resistance, family history and treatment were analyzed, and IAPPSer20Gly mutation was screened by PCR-RFLP and direct sequence analysis.Results: FBG and PBG2h in diabetic patients were significantly higher than those in normal controls (P <0.001) and TG <0.05), average HbA1c (10.4 ± 2.4)%, HOMAIR 3.63 ~ 8.60 .GAD-Ab positive accounted for 3.42% .The family history of diabetes accounted for 61.54% .The diet, exercise therapy and oral drug treatment accounted for 40.6% 41.03%, and 18.65% of insulin treatment.Among the 234 diabetic patients, 2 cases of Ser20Gly mutation of IAPP gene were found, of which 1 case was homozygous and the other 1 case was heterozygous.Conclusion: The incidence of diabetic patients under 40 years of age Obvious metabolic abnormalities and insulin resistance, the incidence of IAPP Ser20Gly mutation in this population is about 0.85%.