1型糖尿病与成人隐匿性自身免疫糖尿病

摘要

The review is aimed to explore the clinical and pathogenic spectrum of autoimmune diabetes including Type 1 diabetes and latent autoimmune diabetes in adults (LADA). Genetic susceptibility modifies age at onset in autoimmune diabetes. The most important genetic susceptibility to Type 1 diabetes and LADA is in the HLA region. Because of the age-related genetic factors, LADA can not be distinguished from classic Type 1 diabetes by genetics. Non-genetic factors contribute much to Type 1 diabetes, but little is known in LADA. Diabetesassociated immune process can occur in early childhood and can be predictive of an ongoing beta cell destruction.The management and prevention of LADA need to be investigated in order to define the best therapeutic strategy.%主要探讨自身免疫糖尿病(包括1型糖尿病和LADA)的临床以及致病谱.遗传易感因素影响了自身免疫糖尿病的发病年龄.1型糖尿病和LADA的最主要的易感基因位于HLA区域.由于年龄相关的遗传影响因素,目前还不能用遗传学的方法来区分LADA和1型糖尿病.非遗传因素在1型糖尿病中有很大的作用,但关于LADA还知之甚少.在低龄儿童中就可有糖尿病相关的免疫过程,这可预测β细胞毁损过程.对于LADA的治疗和预防还需进一步研究以确定最佳方案.