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Diabetes Care:英国儿科单基因糖尿病患病率研究

2016-09-20 Seven L 译 MedSci原创

背景:单基因糖尿病是特殊类型糖尿病中最主要的类型之一。虽然单基因糖尿病是罕见的,但确实儿科糖尿病诊所的一个重要的诊断。这种疾病的识别依赖于临床医生对关键临床特征的识别,随意其诊断往往是不确定的。检测生物标志物(胰岛自身抗体、C-肽)有助于排除这些1型糖尿病患者,并且不依赖于临床医生的识别。本研究通过系统性生物标志物筛查和靶向基因检测,建立英国儿科诊所单基因糖尿病患病率。 方法:研究纳入了英格

背景:单基因糖尿病是特殊类型糖尿病中最主要的类型之一。虽然单基因糖尿病是罕见的,但确实儿科糖尿病诊所的一个重要的诊断。这种疾病的识别依赖于临床医生对关键临床特征的识别,随意其诊断往往是不确定的。检测生物标志物(胰岛自身抗体、C-肽)有助于排除这些1型糖尿病患者,并且不依赖于临床医生的识别。本研究通过系统性生物标志物筛查和靶向基因检测,建立英国儿科诊所单基因糖尿病患病率。

方法:研究纳入了英格兰西南部和泰赛德区6家儿科诊所的808例<20岁的糖尿病患者。利用尿C肽/肌酐比值(UCPCR)测定内源性胰岛素生产。C肽–阳性患者(UCPCR ≥0.2 nmol/mmol)进行胰岛自身抗体(GAD和IA2)测试,自身抗体阴性患者进行基因测试(29个与单基因糖尿病相关基因)。

结果:2.5%的患者(20/808)(95% CI 1.6–3.9%)为单基因糖尿病患者(8例GCK基因, 5例HNF1A基因, 4例HNF4A基因, 1例HNF1B基因, 1例ABCC8基因, 1例INSR基因)。绝大多数(17/20)患者没有使用胰岛素进行管理。纳入的糖尿病患者中,2型糖尿病患者的比例很小(3.3%, 27/808)。

结论:这些数据表明,英国6家儿科诊所中,<20岁糖尿病患者的单基因糖尿病患病率为2.5%。据此估计英国儿科诊所有875例单基因糖尿病患者,∼50%的患者还没有进行基因检测。通过系统性生物标志物筛查可以选择出适合进行基因检测的患儿。

原始出处:

Maggie Shepherd.et al.Systematic Population Screening, Using Biomarkers and Genetic Testing, Identifies 2.5% of the U.K. Pediatric Diabetes Population With Monogenic Diabetes.Diabetes Care 2016 Jun

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  5. [GetPortalCommentsPageByObjectIdResponse(id=1901461, encodeId=f6bb19014613e, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0045169, createdName=木头人513, createdTime=Tue Dec 20 13:52:00 CST 2016, time=2016-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1759768, encodeId=22ca1e59768f2, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Sat Nov 26 03:52:00 CST 2016, time=2016-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1935802, encodeId=79681935802bd, content=<a href='/topic/show?id=2bf336166a6' target=_blank style='color:#2F92EE;'>#单基因糖尿病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36166, encryptionId=2bf336166a6, topicName=单基因糖尿病)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/lGEyfsKnIkkH93xUPMrUUycLh2XOfJJsphwPsVqDx8somSOepIFy9QE0MVAwDW3AS7V1epJ4tbPL9ADJLicvm8A/132, createdBy=b5132500067, createdName=ms55066533437992, createdTime=Tue Sep 27 11:52:00 CST 2016, time=2016-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1637479, encodeId=40a4163e47994, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Tue Apr 18 06:52:00 CST 2017, time=2017-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250440, encodeId=2ce11250440da, content=<a href='/topic/show?id=7d6f52988e1' target=_blank style='color:#2F92EE;'>#患病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52988, encryptionId=7d6f52988e1, topicName=患病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f49517, createdName=xinmeili, createdTime=Thu Sep 22 00:52:00 CST 2016, time=2016-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=131536, encodeId=8b8913153611, content=单基因糖尿病是特殊类型糖尿病中最主要的类型之一, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Tue Sep 20 18:18:00 CST 2016, time=2016-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=131537, encodeId=a64d13153e5e, content=学习啦,,,,, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Tue Sep 20 18:18:00 CST 2016, time=2016-09-20, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1901461, encodeId=f6bb19014613e, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0045169, createdName=木头人513, createdTime=Tue Dec 20 13:52:00 CST 2016, time=2016-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1759768, encodeId=22ca1e59768f2, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Sat Nov 26 03:52:00 CST 2016, time=2016-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1935802, encodeId=79681935802bd, content=<a href='/topic/show?id=2bf336166a6' target=_blank style='color:#2F92EE;'>#单基因糖尿病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36166, encryptionId=2bf336166a6, topicName=单基因糖尿病)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/lGEyfsKnIkkH93xUPMrUUycLh2XOfJJsphwPsVqDx8somSOepIFy9QE0MVAwDW3AS7V1epJ4tbPL9ADJLicvm8A/132, createdBy=b5132500067, createdName=ms55066533437992, createdTime=Tue Sep 27 11:52:00 CST 2016, time=2016-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1637479, encodeId=40a4163e47994, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Tue Apr 18 06:52:00 CST 2017, time=2017-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250440, encodeId=2ce11250440da, content=<a href='/topic/show?id=7d6f52988e1' target=_blank style='color:#2F92EE;'>#患病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52988, encryptionId=7d6f52988e1, topicName=患病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f49517, createdName=xinmeili, createdTime=Thu Sep 22 00:52:00 CST 2016, time=2016-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=131536, encodeId=8b8913153611, content=单基因糖尿病是特殊类型糖尿病中最主要的类型之一, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Tue Sep 20 18:18:00 CST 2016, time=2016-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=131537, encodeId=a64d13153e5e, content=学习啦,,,,, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Tue Sep 20 18:18:00 CST 2016, time=2016-09-20, status=1, ipAttribution=)]
    2016-09-20 医路开来

    单基因糖尿病是特殊类型糖尿病中最主要的类型之一

    0

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    2016-09-20 医路开来

    学习啦,,,,

    0

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