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Clinical Features and Outcome Analysis of Type B Insulin Resistance Syndrome: A Single-Center Study in China.
Zhao, Linlin; Li, Wei; Liu, Lv; Duan, Lian; Wang, Linjie; Yang, Hongbo; Zhang, Huabing; Li, Yuxiu.
Afiliación
  • Zhao L; Department of Endocrinology, Diabetes Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Endocrinology of National Health Commission of the People's Republic of China, Beijing, 100730, China.
  • Li W; Department of Endocrinology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou City, 450052, Henan Province, China.
  • Liu L; Department of Endocrinology, Diabetes Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Endocrinology of National Health Commission of the People's Republic of China, Beijing, 100730, China.
  • Duan L; Department of Endocrinology, Diabetes Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Endocrinology of National Health Commission of the People's Republic of China, Beijing, 100730, China.
  • Wang L; Department of Endocrinology, Benxi Central Hospital, Benxi City, 117000, Liaoning Province, China.
  • Yang H; Department of Endocrinology, Diabetes Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Endocrinology of National Health Commission of the People's Republic of China, Beijing, 100730, China.
  • Zhang H; Department of Endocrinology, Diabetes Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Endocrinology of National Health Commission of the People's Republic of China, Beijing, 100730, China.
  • Li Y; Department of Endocrinology, Diabetes Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Endocrinology of National Health Commission of the People's Republic of China, Beijing, 100730, China.
J Clin Endocrinol Metab ; 109(1): e175-e181, 2023 Dec 21.
Article en En | MEDLINE | ID: mdl-37536271
ABSTRACT
CONTEXT Type B insulin resistance syndrome (TBIRS) is a rare condition, for which effective treatment remains challenging.

OBJECTIVE:

This work aimed to summarize the clinical characteristics of TBIRS and explore effective therapeutic strategies.

METHODS:

The clinical manifestations, biochemical indices, and treatment of 8 patients (3 men and 5 women) with TBIRS from Peking Union Medical College Hospital were retrospectively analyzed and their clinical outcomes were evaluated.

RESULTS:

The average age of the patients was 49.5 ± 16.5 years, and the duration of the disease ranged from 2 months to 1 year. Seven patients with hyperglycemia had normal/lower triglycerides (TGs) and lower insulin-like growth factor 1 (IGF-1) levels. One patient complained of intractable hypoglycemia. Five patients had accompanied systemic lupus erythematosus, 2 had mixed connective tissue disease, and 1 had undifferentiated connective tissue disease. Five patients had acanthosis nigricans and 3 women of child-bearing age had hyperandrogenism. All 8 patients were treated with glucocorticoids combined with immunosuppressants, among whom, 5 received high-dose glucocorticoid pulse therapy followed by conventional-dose glucocorticoid therapy, all of whom achieved partial remission within 2 to 4 weeks. Among the 3 patients receiving conventional glucocorticoid therapy, 2 achieved partial remission within 2 to 4 weeks. Six patients were tracked for 10 weeks to 4 years; 4 and 2 achieved complete and partial remission, respectively.

CONCLUSION:

Decreased serum complement 3 and IGF-1 levels and normal/decreased TG levels act as striking biochemical features of TBIRS. High-dose glucocorticoid pulse therapy followed by conventional-dose long-term therapy combined with immunosuppressants achieves good clinical efficacy.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Enfermedades Autoinmunes / Resistencia a la Insulina / Diabetes Mellitus Límite: Female / Humans / Infant / Male Idioma: En Revista: J Clin Endocrinol Metab Año: 2023 Tipo del documento: Article País de afiliación: China

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Enfermedades Autoinmunes / Resistencia a la Insulina / Diabetes Mellitus Límite: Female / Humans / Infant / Male Idioma: En Revista: J Clin Endocrinol Metab Año: 2023 Tipo del documento: Article País de afiliación: China