Distinguishing Type 2 Diabetes from Type 1 Diabetes in African American and Hispanic American Pediatric Patients

被引：7

作者：

Keller, Nancy ^{[1
,2
]}

Bhatia, Suruchi ^{[3
]}

Braden, Jeanah N. ^{[1
,2
]}

Gildengorin, Ginny ^{[1
,2
]}

Johnson, Jameel ^{[4
]}

Yedlin, Rachel ^{[1
,2
]}

Tseng, Teresa ^{[5
]}

Knapp, Jacquelyn ^{[1
,2
]}

Glaser, Nicole ^{[6
]}

Jossan, Paula ^{[1
,2
]}

Teran, Shawn ^{[1
,2
]}

Rhodes, Erinn T. ^{[7
]}

Noble, Janelle A. ^{[1
,2
]}

机构：

[1] Childrens Hosp, Oakland, CA 94609 USA

[2] Res Ctr Oakland, Oakland, CA USA

[3] Sutter Pacific Med Ctr, Div Endocrinol & Diabet, San Francisco, CA USA

[4] Michael E DeBakey VA Med Ctr, Houston, TX USA

[5] Univ Texas SW, Childrens Med Ctr, Dallas, TX 75390 USA

[6] UC Davis, Med Ctr, Dept Pediat, Sacramento, CA USA

[7] Childrens Hosp Boston, Div Endocrinol, Boston, MA USA

来源：

PLOS ONE | 2012年 / 7卷 / 03期

基金：

美国国家卫生研究院;

关键词：

CLINICAL CHARACTERISTICS; YOUTH PREVALENCE; CHILDREN; ADOLESCENTS; OBESITY; ONSET; SEARCH; AGE; PERIOD; RISK;

D O I：

10.1371/journal.pone.0032773

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Objective: To test the hypothesis that clinical observations made at patient presentation can distinguish type 2 diabetes (T2D) from type 1 diabetes (T1D) in pediatric patients aged 2 to 18. Subjects and Methods: Medical records of 227 African American and 112 Hispanic American pediatric patients diagnosed as T1D or T2D were examined to compare parameters in the two diseases. Age at presentation, BMI z-score, and gender were the variables used in logistic regression analysis to create models for T2D prediction. Results: The regression-based model created from African American data had a sensitivity of 92% and a specificity of 89%; testing of a replication cohort showed 91% sensitivity and 93% specificity. A model based on the Hispanic American data showed 92% sensitivity and 90% specificity. Similarities between African American and Hispanic American patients include: (1) age at onset for both T1D and T2D decreased from the 1980s to the 2000s; (2) risk of T2D increased markedly with obesity. Racial/ethnic-specific observations included: (1) in African American patients, the proportion of females was significantly higher than that of males for T2D compared to T1D (p<0.0001); (2) in Hispanic Americans, the level of glycated hemoglobin (HbA1c) was significantly higher in T1D than in T2D (p<0.002) at presentation; (3) the strongest contributor to T2D risk was female gender in African Americans, while the strongest contributor to T2D risk was BMI z-score in Hispanic Americans. Conclusions: Distinction of T2D from T1D at patient presentation was possible with good sensitivity and specificity using only three easily-assessed variables: age, gender, and BMI z-score. In African American pediatric diabetes patients, gender was the strongest predictor of T2D, while in Hispanic patients, BMI z-score was the strongest predictor. This suggests that race/ethnic specific models may be useful to optimize distinction of T1D from T2D at presentation.

引用

页数：7

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