Metabolic Disorders in Children and Adolescents with Type 2 Diabetes Mellitus

罹患第2型糖尿病的兒童與青少年之代謝異常

黃琪鈺(Chi-Yu Huang) ； 李欣蓉(Hsin-Jung Li) ； 羅福松(Fu-Sung Lo) ； 王安美(An-Mei Wang) ； 施並富(Bing-Fu Shih) ； 林昭旭(Chao-Hsu Lin) ； 陳銘仁(Ming-Ren Chen) ； 李宏昌(Hung-Chang Lee) ； 李燕晉(Yann-Jinn Lee)

《Acta Paediatrica Taiwanica》 47卷4期 (2006/08) Pp. 187-191

https://doi.org/10.7097/APT.200608.0187

摘要

背景：全世界兒童和青少年肥胖的盛行率正逐年增加，第2 型糖尿病在兒童和青少年的發生率也隨之增加。於1992年到1999年間，台灣地區6-18歲學童尿液篩檢發現，第2型糖尿病佔了新診斷的糖尿病的54.2%，其相關因子包括高膽固醇、高血壓和第2型糖尿病家族史。
方法：我們針對22 位第2 型糖尿病孩童（平均年齡11.7±2.3歲，6個男孩），237位肥胖孩童（平均年齡11.6±2.1歲，135個男孩）以及42個對照組健康孩童（平均年齡12.1±2.1歲，25個男孩）進行身體檢查，取得其身高、體重以計算身體質量指數(BMI)，檢驗其空腹血糖、胰島素（計算HOMA-IR）、膽固醇、三酸甘油酯、低密度脂蛋白－膽固醇、高密度脂蛋白－膽固醇、尿酸、及肌酸酐值，比較各組間的差異。我們並分析第2型糖尿病組的年齡，性別，過重和肥胖，黑棘皮症所佔的比例。
結果：研究結果發現第2 型糖尿病組男女比是1：2.7，18%過重，68%肥胖，64%有黑棘皮症。第2型糖尿病組和肥胖組的血液生化值除了前者血糖較高，其他項目無差異。第2型糖尿病組比對照組有較高的HOMA-IR、膽固醇和三酸甘油酯，但較低的高密度脂蛋白－膽固醇。肥胖組比對照組有較高的HOMA-IR、膽固醇、三酸甘油酯和尿酸，但較低的高密度脂蛋白－膽固醇。
結論：我們建議高危險群的孩童(肥胖、黑棘皮症)應定期篩檢第2型糖尿病和相關的代謝異常。

關鍵字

第2型糖尿病 ； 肥胖 ； 黑棘皮症 ； 代謝異常 ； 兒童

並列摘要

Background: Type 2 diabetes mellitus (T2DM) in children and adolescents is increasing in incidence worldwide. It is the leading type of newly diagnosed diabetes in Taiwan among school children. T2DM is associated with metabolic syndrome in adults, so we tried to find out if these metabolic disorders are present in children.
Methods: From 1989 to 2003, 22 children and adolescents were diagnosed with T2DM in our hospital. Their ages ranged from 8.8 to 17.0 (11.7±2.3) years; 6 of them were boys. We compared their clinical characteristics with those of 42 healthy and 237 obese children and adolescents. Physical examination was performed and plasma glucose and serum cholesterol, triglycerides, uric acid, creatinine, HDL-cholesterol, and insulin levels were measured and LDL-cholesterol was calculated. Demographic and laboratory data were compared among the T2DM, obese and control groups.
Results: The female: male ratio among the patients was 2.7: 1; 18% were overweight and 68% obese, and 64% had acanthosis nigricans. There were no significant differences between the T2DM and obese groups in terms of biochemistry profiles except for the higher plasma glucose in the T2DM group. Children with T2DM had higher levels of cholesterol and triglycerides but lower levels of HDL-cholesterol compared with healthy children. Among obese children without T2DM, the levels of glucose, triglycerides, uric acid, insulin, HOMA-IR were higher than in the healthy group, and HDL-cholesterol levels were lower.
Conclusions: Children with T2DM or obesity should be evaluated for metabolic disorders.

並列關鍵字

type 2 diabetes mellitus ； obesity ； acanthosis nigricans ； metabolic disorders ； children