Objective To investigate the clinical characteristics and primary classification of diabetes in children and adolescents. Methods According to fasting C-peptide level, 36 children and adolescents with diabetes were divided into two groups: decreased C-peptide group (fasting C-peptide level<0.60 μg/L, n=24) and normal C-peptide group (fasting C-peptide level≥0.60 μg/L, n=12). Clinical characteristics were compared between two groups. Results Compared with decreased C-peptide group, normal C-peptide group had significantly higher proportion of acanthosis nigricans, family history of type 2 diabetes, metabolic syndrome and overweight/obesity (P< 0.01 or P<0.05). The levels of body mass index, waist circumference, fasting C-peptide, postprandial C-peptide and A C-peptide in normal C-peptide group were significantly higher than those in decreased C-peptide group (all P<0.01). The rate of positive glutamic acid decarboxylase antibody/protein tyrosine phosphate antibody, concurrent ketosis/ke-toacidosis and underweight in normal C-peptide group was significantly lower than that in decreased C-peptide group. (P<0.01 or P<0.05) Normal C-peptide group showed significantly lower levels in random blood glucose and β hy-droxybutyric acid than those in decreased C-peptide group (P<0.01 or P<0.05). Conclusion According to fasting C-peptide level, children and adolescents with diabetes can be primary classified. Decreased C-peptide group is more likely to be classified as type 1 diabetes, and normal C-peptide group is more likely to be classified as type 2 diabetes.%目的 探讨儿童青少年糖尿病患者的临床特征和初步分型.方法 根据空腹C肽水平将36例儿童青少年糖尿病患者分为C肽降低组(空腹C肽＜0.60 μg/L,24例)和C肽正常组(空腹C肽≥0.60 μg/L,12例),比较两组患者的临床资料.结果 C肽正常组黑棘皮症、2型糖尿病家族史、代谢综合征及超重/肥胖者的比例明显高于C肽降低组(P＜0.01或P＜0.05),体质指数、腰围、空腹C肽、餐后2 h C肽及餐后C肽增加值水平明显高于C肽降低组(均P＜0.01),谷氨酸脱羧酶抗体/蛋白酪氨酸磷酸酶抗体阳性率、并发酮症/酮症酸中毒及低体重者的比例明显低于C肽降低组(P＜0.01或P＜0.05),随机血糖及血β羟丁酸水平明显低于C肽降低组(P＜0.01或P<0.05).结论 根据空腹C肽水平可对儿童青少年糖尿病患者初步分型,C肽降低组更倾向于1型糖尿病,C肽正常组更倾向于2型糖尿病.
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