Prevalence of and risk factors for diabetic ketosis in Chinese diabetic patients with random blood glucose levels >13.9 mmol/L: Results from the CHina study in prEvalence of diabetiC Ketosis (CHECK) study
随机血糖> 13.9 mmol/L 的中国糖尿病患者糖尿病酮症患病率及危险因素分析:来自中国糖尿病酮症(CHECK)研究的结果
Abstract
enBackground
The aim of the present study was to investigate the prevalence of diabetic ketosis (DK) and its risk factors in Chinese diabetes patients with severe hyperglycemia.
Methods
The present multicenter cross-sectional study was performed on patients aged >16 years with diabetes mellitus (DM) and random blood glucose levels >13.9 mmol/L (>250 mg/dL). Blood ketones (β-hydroxybutyric acid) and urinary ketones (acetoacetic acid) were measured and information on patient demographic and clinical characteristics was collected.
Results
Of 1235 patients enrolled in the study (93 with type 1 DM [T1DM]), 1142 with type 2 DM [T2DM]), 242 (19.6%) had DK (blood ketone levels ≥0.6 mmol/L). Proportionately, DK was more frequent and more severe in patients with T1DM than T2DM (55.9% vs 16.6%, respectively), but in absolute terms occurred in more patients with T2DM (52 vs 190). In patients with blood ketone levels ≥3 mmol/L, the cut-off point of blood glucose levels was 19.05 mmol/L. Risk factors significantly associated with higher blood ketone levels in T2DM included younger age, a shorter duration of diabetes, and not using antidiabetic medication within 12 months prior to the hyperglycemic episode.
Conclusions
The prevalence of DK is lower in patients with T2DM than T1DM, but the number of patients with DK is higher for those with T2DM because of more T2DM patients in China. Patients with T2DM who have a younger age, shorter duration of diabetes, and a lack of antidiabetic treatment will suffer from DK more often than older patients with longer T2DM duration and receiving antidiabetic treatment.
摘要
zh背景
本研究旨在调查有严重高血糖症状的中国糖尿病患者中糖尿病酮症患病率及危险因素。
方法
本研究为多中心、横断面调查。年龄16岁以上、随机血糖> 13.9 mmol/L(> 250 mg/dL)的糖尿病患者入选本研究。测定患者的血酮(β-羟丁酸)和尿酮(乙酰乙酸)。收集患者的人口学信息和相关临床资料。
结果
1235例患者入选本研究(93例1型糖尿病和1142例2型糖尿病), 242例(19.6%)被诊断为糖尿病酮症(快速血酮 ≥ 0.6 mmol/L)。相对应地, 1型糖尿病患者的酮症患病率更高(1型糖尿病酮症患病率55.9% , 2型糖尿病酮症患病率16.6%)并且程度更严重, 但2型糖尿病患者酮症的绝对数量更多(1型糖尿病52例酮症, 2型糖尿病190例酮症)。快速血糖≥ 19.05 mmol/L是快速血酮水平≥ 3 mmol/L的血糖诊断切点。与2型糖尿病患者血酮升高显著相关的危险因素包括:年龄小、糖尿病病程短、在高血糖发生前12个月未采取降糖药物治疗。
结论
在中国严重高血糖的患者中, 2型糖尿病患者的酮症患病率低于1型糖尿病, 但其酮症患者的绝对数量更高, 因为2型糖尿病患者数目更多。2型糖尿病患者发生酮症的危险因素包括年轻、糖尿病病程短、未及时采取降糖药物治疗。
