| ObjectTo investigate the clinical characteristics in anti-islet autoantibody-negative ketosis-prone diabetic (KPD) patients with metabolic syndrome (MS)DesignCross-sectional and case control retrospective study.MethodsOne hundred and eighty nine anti-islet autoantibody-negative KPD patients, 201 type 2 diabetes (T2DM) were enrolled for this study. MS was diagnosed according to the definitions proposed by the international Diabetes Federation (IDF) in 2005. Anti-islet autoantibody-negative KPD patients were divided into two groups: with MS (KPD MS+), without MS (KPD MS-). T2DM were also divided into T2DM MS- group and T2DM MS+ group. The prevalence of MS was investigated in anti-islet autoantibody-negative KPD and clinical characteristics were compared between KPD MS+ and the other three groups.Results(1)Among the 189 KPD patients, 47(25%) met the criteria of MS. (2) Compared with KPD MS- group, the KPD MS+ group were older (39.2±13.0 vs. 34.2±14.8 years, P=0.04) when diagnosed of diabetes. The KPD MS+ group had significantly higher BMI, waist circumference, hip circumference, WHR, blood pressure, TG, FBS, PBS, Fasting C-peptide(FCP) [431 (37-3310) vs. 193 (0-995) pmol/L, P=0.008], Postprandial C-peptide(PCP) [815 (7-4191) vs. 394 (0-4452) pmol/L, P=0.007] and HOMA2-IR [2.0 (0.6-5.6) vs. 1.2 (0.4-3.8), P<0.001]. (3) Compared with T2DM MS+ group, At presentation, the KPD MS+ group had significantly lower FCP [431(37-3310) vs. 574(105-2344) pmol/L, P=0.003], PCP [815 (8-4191) vs. 1291 (164-6615) pmol/L, P=0.001] and higher HbAlc levels (10.5±2.7 vs. 9.33±2.5, P=0.017), the KPD MS+ group dominantly is male, which male female ratio is higher (3.3:1 vs. 0.9:1, P=0.001), the KPD MS+ group is younger when diagnosed of diabetes (39.2±13.0 vs. 51.1±11.0 years, P<0.001), had more patients with family history of diabetes (40% vs. 9%, P=0.002). However, there was no significant difference in HOMA2-IR between these two groups. (4) Compared with T2DM MS- group, at presentation, the KPD MS+ group had higher HOMA2-IR [2.0 (0.6-5.6) vs. 1.2 (0.5-7.9), P<0.001],HbAlc [10.6(5.0-15.4) vs. 9.1(4.2-18.0), P=0.017] levels, the KPD MS+ group were younger when diagnosed of diabetes (39.2±13.0 vs. 51.1±12.2 years old, P<0.001). However, there was no significant difference in FCP, PCP levels between these two groups. (5) At the end of three years following, the FCP of KPD MS+ group is 688(12-1388) pmol/L and KPD MS- group is 281(0-1132) pmol/L. KPD MS+ group had higher FCP than KPD MS- group at onset,half one year and two years after diagnosis of diabetes.Conclusions(1) Our findings indicated that MS did exist in anti-islet autoantibody-negative KPD. According to the 2005 IDF definition, the prevalence of MS in antibody-negative KPD is about 25% in Hunan, Chinese. (2) Compared with KPD MS- group, KPD MS+ group had betterβ-cell function and higher H0MA2-IR at onset, which is similar with T2DM MS-. Compared with T2DM MS+ group, KPD MS+ group had lowerβ-cell function but similar H0MA2-IR at onset. (3) During 3 years of following, KPD MS+ patients still had betterβ-cell function than KPD MS- patients.
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