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目的:探讨新诊断1型糖尿病患者胰岛功能水平及其影响因素.方法:选取2010年1月-2015年12月在南京医科大学第一附属医院内分泌科住院治疗的新诊断1型糖尿病患者105例,测糖化血红蛋白、胰岛自身抗体及HLA-A和-DR位点,控制血糖＜10 mmol/L后行混合餐试验,测血糖、胰岛素及C肽,计算峰值C肽≥0.2 nmol/L的比例,并采用Logistic回归分析影响新诊断1型糖尿病患者胰岛功能的因素.结果:89.5％的患者初诊时峰值C肽≥0.2 nmol/L.初诊年龄≤18岁(OR=0.08,95％CI:0.01～0.90),酮症或酮症酸中毒起病(OR=0.08,95％CI:0.01～0.83),携带高危HLA-A-DRB1基因单倍型(OR=0.07,95％ CI:0.01～0.61),胰岛自身抗体阳性数＞2(OR=0.10,95％CI:0.01～0.87)者峰值C肽≥0.2 nmol/L率更低.结论:1型糖尿病患者初诊时仍有部分胰岛功能.因此,胰岛功能不能作为鉴别诊断1型或2型糖尿病的唯一依据.新诊断1型糖尿病患者胰岛功能与初诊年龄、酮症或酮症酸中毒起病、HLA-A-DRB1基因单倍型及胰岛自身抗体有关.“,”Objective:To describe the levels of residual β-cell function in patients with newly-onset type 1 diabetes mellitus,and investigate factors that may be related.Methods:Data obtained from 105 newly-onset hospitalized type 1 diabetes mellitus patients in the First Affiliated Hospital of Nanjing Medical University from 2010 to 2015.Hemoglobin A1c,islet autoantibodies and HLA-A-DR haplotypes were tested.Mixed-meal tolerance test was carried out until the fasting blood glucose was lower than 10 mmol/L;blood glucose,insulin and C-peptide were measured during the test.The rates of peak C-peptide ≥ 0.2 nmol/L were calculated and logistic regression analyses were performed to explore the influence factors.Results:Eighty-night point five percent of patients had peak C-peptide ≥ 0.2 nmol/L.Logistic regression analyses suggested that factors including age of onset ≤ 18(OR 0.08,95％ CI 0.01～0.90),diabetic ketosis or ketoacidosis onset (OR 0.08,95％ CI 0.01 ～0.83),High-risk HLA-A-DRB 1 haplotypes (OR 0.07,95％ CI 0.01～0.61),counts of islet autoantibodies ＞2 (OR 0.10,95％ CI 0.01～0.87) were related to lower rates of peak C-peptide ≥ 0.2 nmol/L.Conclusion:We found that residual β-cell function exists in patients with newly-onset type 1 diabetes mellitus.These data reinforce the inadvisability of using C-peptide alone to differentiate between type 1 diabetes mellitus and other forms of diabetes.We also found that age of onset,diabetic ketosis or ketoacidosis onset,HLA-A-DRB1 haplotypes and islet autoantibodies were associated with β-cell function in patients with newly-onset type 1 diabetes mellitus.