初诊不同年龄组2型糖尿病患者代谢特征差异分析

目的研究不同年龄初诊2型糖尿病（T2DM）患者临床代谢特征。方法202例初诊T2DM患者按年龄分为青年组、中年组和老年组，比较3组在体重指数（BMI）、血压、血糖、血脂、血尿酸、胰岛素、胰岛素抵抗指数（HOMA—IR）及0细胞功能指数（HOMA—β）等方面的差别。结果青年组具有最高的BMI、血尿酸、吸烟率及HOMA—IR；老年组具有最高的空腹血糖（FPG）、糖化血红蛋白（HbAlc）、尿白蛋白（UAlb）、血压及高血压患病率；中年组的血压、血尿酸、UAlb、吸烟率及甘油三酯较高。3组间HOMA—β无统计学差异。青年组HOMA—IR与HbAlc、高密度脂蛋白相关（r=0．499、r=-0．643），HOMA—B与总胆固醇相关（r=-0．519）；中年组HOMA-β与BMI、HbAlC相关（r=0．555，r=-0．481）；老年组HOMA—IR及HOMA—β与代谢参数间无相关性。结论初诊T2DM代谢异常特征随年龄不同而不同，青年T2DM患者表现为肥胖与胰岛素抵抗，中老年T2DM患者以高血压与高白蛋白尿为特征。

Analysis of the differences in the metabolic characteristics of type 2 diabetes mellitus in the newly diagnosed patients of different age groups

Objective To investigate the clinical metabolic characteristics of type 2 diabetes mellitus （T2DM） in newly diagnosed patients of different age groups. Methods 202 patients newly diagnosed as T2DM were divided into three groups according to age： youth （≤39） , middle -aged （40 to 59） and elderly （≥60） groups. Clinical character- istics including body mass index （BMI） , blood pressure, fasting and postprandial plasma glucose, HbAle, lipid profiles, urinary albumin （UAlb） , insulin, insulin resistance index （ HOMA - IR） and β - cell function （ HOMA - β） were determined and compared. The history of smoking and high blood pressure were also recorded. Insulin sensitivity was determined by HOMA - IR, and β cell function determined by HOMA - β. Results The youth group had the high- est levels of BMI, uric acid, smoking rate and HOMA - IR; the elderly group had highest levels of fasting plasma glucose （ FPG）, HbAlc, UAlb and percentage of hypertension, and the middle aged group had higher blood pressure, uric acid, UAlb, triglyceride and smoking rate, but lower HOMA - IR compared with the other two groups, while the differences in HOMA - β were not statistically significant. In the youth group, the HOMA - IR was correlated with HbAlc and HDL - C （r =0.499,r = -0. 643）, and the HOMA-β correlated with total cholesterol （r = -0.519）. In the middle- aged group, HOMA -β was correlated with BMI and HbA1 c （ r = 0.555, r = - 0. 481 ）. In the elderly group, neither HOMA - IR nor HOMA - β was correlated with metabolic parameters. Conclusion The abnormal metabolism in newly diag- nosed patients with T2DM vary with age, and is characterized by obesity and insulin resistance, while in middle -aged and elderly patients characterized by hypertension and hyperalbuminuria.