成人迟发自身免疫糖尿病的诊治进展

Diagnositic and Therapeutic Progress of Late-onset Autoimmune Diabetes in Adults

成人迟发自身免疫糖尿病(LADA)属于1型糖尿病,但其早期表现与2型糖尿病相似。LADA与经典1型糖尿病的区别在于其胰岛β细胞所受免疫损害呈缓慢性,因此其可作为l型糖尿病免疫学研究的一种人类模型。尽管临床上还没有明确对于该疾病的国际诊断标准,LADA的诊断应从临床特征、易感基因、免疫标志、组织病理等方面综合考虑,其中胰岛自身抗体是诊断LADA的重要指标。早期应用胰岛素可能对部分LADA患者胰岛细胞有保护作用。研究LADA患者的病理改变有助于了解β细胞的免疫破坏进程,并为1型糖尿病的预防甚至治愈提供依据。

Late-onset autoimmune diabetes in adults （LADA）. presenting with a similar phenotype of type 2 diabetes at early stage, belongs to the slowly progressive subtype of autoimmune type 1 diabetes. The difference between LADA and classic juvenile-onset type 1 diabetes is that its autoimmune destructive process of islet betacells is much slower. LADA may serve as a human model of autoimmune type 1 diabetes. Although no international standardized criteria for the diagnosis of LADA has been established, it should be noted that the diagnosis of LADA shuould be based on many aspects including clinical characteristics, susceptible genotypes, cellular and humoral immune markers, as well as islet pathology, in which autoantibody of islets is the important index in diagnosing LADA. Studying the pathological changes wil be helpful to know the immune destructive process of βcells as well as provide the basis for the prevention or even cure of type 1 diabetes.