Studies On The Clinical Features Of FT1DM And Correlation With HLA-DQ A1 Gene

Objective:To explorer the clinical features of FT1 DM and correlation with HLA-DQ A1 gene.Methods:FT1DM patients and T1 ADM patients in the First Affiliated Hospital of Guangxi Medical University between 2005 and January 2018 were selected.FT1 DM patients were treated as experimental group(FT1DM group)and classic type 1 diabetes mellitus were treated as control group(T1ADM group).Collected the clinical data of patients and used polymerase chain reaction technology to detected HLA-DQ A1 gene,then compare their clinical features,the frequencies of HLA-DQ A1 alleles between groups and follow-up of islet function and diabetic complications of FT1 DM.Results:1.There were 39 FT1 DM cases met the diagnostic criteria of FT1 DM,and from June 2012 to January 2018,there were 29 FT1 DM cases,accounted for about3.7%(29/784)in T1 DM.2.In the 39 FT1 DM,only 12 cases were diagnosed as FT1 DM,the missed diagnosis rate was as high as 69.2%,and male FT1 DM accounted for about53.8%(21/39)and female FT1 DM accounted for about 46.2%(18/39).3.The average onset age of FT1 DM was 29.0(24.0,33.0)years old,the age totally ranged from 16 to 69 years old.4.FT1 DM can be seen from Nanning,Baise,Beihai,Hechi and other places.It was distributed by multiple ethnic groups such as Han,Zhuang,and other nationalities.5.The rates of pregnancy-related,flu-like symptoms,gastrointestinal symptoms and rashes in FT1 DM were higher than the new T1ADM(P<0.05).The rate of GADA positive and hyperglycemia symptoms were lower than the new T1ADM(P<0.05).No significant difference was found in the rate of female ratio,diabetes family history,abnormal B-ultrasonography or CT of pancreas(P>0.05).6.FT1 DM showed higher age,BMI,blood glucose level,D-3-H,insulin dosage,ALT,AST,Cr,K+,AMS,and shorter disease course,lower Hb A1 c,FCP,PCP,arterial blood p H,BE,CK-MB than new T1ADM(P<0.05).Between FT1 DM and T1 ADM,there was no significant difference in Na+,CL-,CK(P>0.05).7.Multiple logistic regression analysis in FT1 DM showed that women[OR=4.536,OR 95%CI(1.011,20.350)],BMI(partial regression coefficient=0.184,OR=1.202),PCP(partial regression coefficient=-6.789,OR=0.001).8.Hb A1 c increased in FT1 DM at follow-up(P<0.01).Both FCP and PCP were very low and there was no significant difference in FCP,PCP and insulin dosage between the onset and follow-up(P>0.05).Four FT1 DM cases of GADA positive at the onset turned negative,three FT1 DM cases developed diabetic macroangiopathy and two FT1 DM cases developed diabetic peripheral neuropathy at follow-up.9.The frequency of HLA-DQA1*0102 allele in FT1 DM group was higher than T1 ADM group(P < 0.05,OR=2.348,95 CI : 1.119,4.927),and HLA-DQA1*0302 allele was lower than T1 ADM group(P<0.01,OR=0.288,95CI:0.113,0.732)?Conclusion:1.FT1 DM was not rare and most of them were adults,but the rate of missed diagnosis was high.2.FT1 DM has more complex clinical manifestations and more serious metabolic disorders than T1 ADM.3.The pancreatic islet ? cells were rapidly and almost completely destroyed when FT1 DM started,and there was no recovery trend in islet function after long-term follow-up.After FT1 DM started,Diabetic complications were observed within 5 years.4.Female and BMI may be the risk factors of FT1 DM,and PCP may be the protective factor.5.HLA-DQA1*0102 allele may increase the risk of FT1 DM and HLA-DQA1*0302 allele may decrease the risks of FT1 DM.