SOX13抗体对急性起病自身免疫糖尿病的诊断意义

Diagnostic value of SOX13 antibody in acute-onset autoimmune diabetes

目的探讨SOX13抗体(SOX13Ab)对急性起病自身免疫糖尿病的诊断价值。方法162例急性起病糖尿病患者根据谷氨酸脱羧酶抗体(GADAb)和蛋白酪氨酸磷酸酶抗体(IA2Ab)阳性与否分为经典[GADAb和(或)IA2Ab阳性]和非经典1型糖尿病(DM)(GADAb和IA2Ab均阴性)两亚组,正常对照组120名,分析SOX13Ab分布规律、该抗体阳性患者临床特征及其对胰岛功能的影响。结果(1)急性起病组和经典1型DM亚组SOX13Ab阳性率均高于正常对照组(9.3%vs2.5%,9.9%vs2.5%;均P<0.05);SOX13Ab(+)/GADAb(+)双阳性者6例(3.7%),无1例SOX13Ab(+)/IA2Ab(+)双阳性者;(2)SOX13Ab分布峰值处于发病年龄61～70岁;(3)SOX13Ab单一阳性组临床特征(包括代谢综合征相关指标异常程度等)与GADAb、IA2Ab单一阳性和抗体阴性组间差异无统计学意义(P>0.05);(4)SOX13Ab单一阳性组C肽介于GADAb、IA2Ab单一阳性和抗体阴性组之间。结论SOX13Ab检测可提高诊断急性起病自身免疫糖尿病的敏感性。

Objective To explore the diagnostic value of SOX13 antibody in acute-onset autoimmune diabetes. Methods One hundred and sixty-two patients with acute-onset diabetes were divided into typical and atypical type 1 DM subgroups to analyse the distribution of SOX13-Ab across the spectrum of acute-onset diabetes. According to SOX13-Ab, glutamic acid decarboxylase antibody （GAD-Ab） and protein tyrosine phosphatase antibody （IA-2Ab） status, the cases were then divided into SOX13-Ab, GAD-Ab, IA-2Ab positive groups and autoantibody-negative group and their clinical characteristics were compared. The effect of SOX13-Ab on isletβ-cell function was evaluated by comparison of C-peptide among the four subgroups. Results The positive rate of SOX13-Ab in acute-onset diabetes and typical type 1 DM were higher than that in normal controls（9.3% vs 2.5% ,9.9% vs 2.5% ;both P〈0.05）. Six patients were positive for both SOX13-Ab and GAD-Ab（3.7%） , but none was positive for both SOX13-Ab and IA-2Ab. The highest positive rate of SOX13-Ab was observed in patients with age of onset 61～70yr. There were no differences in the clinical parameters （mainly related to blood glucose and metabolic syndrome） among four diabetic subgroups. The C-peptide levels in SOX13-Ab positive patients were between those of GAD-Ab, IA-2Ab positive and autoantibody-negative patients. Conclusions The SOX13-Ab testing could improve the sensitivity for screening acute-onset autoimmune diabetes.