<p>Prevalence and Gender Differences of Metabolic Syndrome in Young Ketosis-Prone Type 2 Diabetic Individuals: A Retrospective Study</p>

Abstract

This study aimed to identify the prevalence and gender differences of metabolic syndrome in young new-onset ketosis-prone type 2 diabetic (KPT2D) individuals. Patients and Methods: A retrospective study was conducted in Shanghai Xin Hua Hospital from 2007 to 2019. A total of 304 patients from 12 to 40 years of age with newly diagnosed diabetes presenting with ketosis were analyzed. The clinical features and laboratory results of KPT2D and type 1 diabetic (T1D) individuals were compared. Prevalence and gender differences of metabolic syndrome in the KPT2D subjects were analyzed. Results: The prevalence of metabolic syndrome (P < 0.0001) was significantly higher in young KPT2D than T1D subjects. The prevalence of high blood pressure (P < 0.0001), central obesity (P < 0.0001), low plasma HDL-C concentration (P = 0.045), and hypertriglyceridemia (P < 0.0001) was elevated in the KPT2D subjects compared with T1D. Male predominance (89%) was presented in the KPT2D subjects. The prevalence of metabolic syndrome (P = 0.0002) was significantly higher in young male than female KPT2D subjects. The presence of central obesity (P < 0.0001) and high blood pressure (P =0.03) was higher in male KPT2D subjects than female. The presence of serum triglyceride concentrations ≥ 2.3mmol/L was significantly higher (P = 0.011) in male KPT2D subjects than female. Conclusion: Significantly higher prevalence of metabolic syndrome in young KPT2D patients compared with T1D patients could be an important reference for diabetic differential diagnosis. KPT2D presented a higher predominance in young males, who had higher prevalence of metabolic syndrome than young females.

Elevated Serum Triglycerides are Associated with Ketosis-Prone Type 2 Diabetes in Young Individuals

“… 2 Zhang et al have reported 7.6% prevalence of KPT2D in young diabetic patients in China 3 and Nagasaka et al reported approximately 10% in Japan. 4 KPT2D has been shown to have better retention of β-cell functions compared to T1D, but exhibits stronger insulin resistance and temporarily suppressed β-cell functions compared to the classical T2D in our 5 and other previous studies. 6 , 7 Similar to patients with T2D, those with KPT2D are also likely to be overweight and have a strong family history of diabetes.…”

“…The exclusion criteria for this study were consistent with our previous report. 5 Cases with T1D were excluded due to dependence on insulin treatment, positivity for β-cell autoantibodies, and undetectable/low levels of plasma C-peptide. The diagnosis of T2D was based on the America Diabetes Association Guidelines of 2006, with fasting plasma C-peptide > 0.33 nmol/L 9 and without ketosis or ketoacidosis.…”

“… 5 Briefly, KPT2D patients were new-onset T2D patients with unprovoked ketosis or diabetic ketoacidosis as the primary symptom. 5 All enrolled patients (both KPT2D and T2D) were negative for islet cell autoantibodies (ICAs), glutamate decarboxylase autoantibodies (GADs), and insulin autoantibodies (IAAs). The anthropometric measurements and clinical data collections were consistent with previous research.…”

“…The anthropometric measurements and clinical data collections were consistent with previous research. 5 …”

“…6,7 Similar to patients with T2D, those with KPT2D are also likely to be overweight and have a strong family history of diabetes. [5][6][7] Therefore, KPT2D has also been called the Flatbush, idiopathic, or type 1.5 diabetes. It has been reported that glucotoxicity characterized by high levels of glycosylated hemoglobin A1c (HbA1c) can suppress β-cell functions, resulting in ketosis or ketoacidosis in individuals with KPT2D.…”