Is type 1 diabetes in the Japanese population the same as among caucasians?
Is type 1 diabetes in the Japanese population the same as among caucasians?
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DOI：
10.1196/annals.1337.014
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发表时间：
2004-01-01
期刊：
影响因子：
--
通讯作者：
Eguchi, K
中科院分区：
文献类型：
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作者：
Kawasaki, E;Eguchi, K
在日本人群中，1型糖尿病的发病率低至2例/年/100，000名儿童，远低于主要为高加索人的国家。然而，在日本1型糖尿病患者中，发病时抗胰岛自身抗体的患病率为GAD自身抗体60-70%，胰岛素自身抗体（IAA）45-50%，IA-2自身抗体60-65%，这与高加索患者中报道的相似。通过对这些自身抗体的组合分析，90%的患者表达这些自身抗体中的至少一种，并被分类为1A型糖尿病。在日本，有相当数量的成人隐匿性自身免疫性糖尿病（LADA）患者，高水平的GAD自身抗体对此类患者未来的胰岛素缺乏具有很高的预测价值。近年来，有报道称一组起病极快的患者表现为糖尿病酮症酸中毒和低HbA 1c水平，称为暴发性糖尿病。虽然他们有严重的高血糖症，这些人缺乏抗胰岛自身抗体的表达。在一项全国性调查中，据记录，暴发性1型糖尿病占日本1型糖尿病酮症发作患者的20%。目前尚不清楚暴发性1型糖尿病的发病机制是否与胰岛β细胞的自身免疫反应有关。日本的1型糖尿病患者临床上具有异质性，需要进一步研究以阐明1型糖尿病各亚组的潜在发病机制。
In the Japanese population, the incidence of type 1 diabetes is as low as similar to 2 cases/year/100,000 children, which is much lower compared to that in countries with populations predominantly of Caucasian origin. However, the prevalences of anti-islet autoantibodies in patients with Japanese type 1 diabetes are 60-70% for GAD autoantibodies, 45-50% for insulin autoantibodlies (IAA), and 60-65% for IA-2 antoantibodies at disease onset, which are similar to those reported in Caucasian patients. With combinatorial analysis of these autoantibodies, 90% of patients express at least one of these autoantiboolies and are classified as type 1A diabetics. There is a significant number of patients with latent autoimmune diabetes in adults (LADA) in Japan, and a high level of GAD autoantibodies has a high predictive value for future insulin deficiency in such patients. Recently, it has been reported that a group of extremely rapid-onset patients presented with diabetic ketoacidosis and a low HbA1c level, called fulminant diabetes mellitus. Although they had severe hyperglycemia, these individuals lacked the expression of anti-islet autoantibodies. With a nationwide survey, it was documented that fulminant type 1 diabetes accounts for similar to 20% of the ketosis-onset patients with type 1 diabetes in Japan. It is currently unknown whether the pathogenesis of fulminant type 1 diabetes is associated with autoimmune response to pancreatic islet beta cells. Japanese patients with type 1 diabetes are clinically heterogeneous, and further investigations are required to clarify the underlying pathogenesis for each subgroup of type 1diabetes.