GAD-Ab、ICA检测在糖尿病分型诊断中的临床价值

Clinical Value of Serum Glutamic Acid Decarboxylase Antibody and Islet Cell Antibody Test in Typing Diagnosis of Diabetes Mellitus

目的探讨血清谷氨酸脱羧酶抗体(GAD-Ab)、胰岛细胞抗体(ICA)联合检测对糖尿病分型的诊断价值。方法采用RIA法和ELISA法测定138例糖尿病患者及38例正常人的血清GAD-Ab、ICA水平。结果1型糖尿病患者GAD-Ab、ICA阳性率分别为57.1%和38.8%,联合检测阳性率为91.8%,与其他组比较差异有统计学意义(P<0.01);2型糖尿病患者GAD-Ab、ICA阳性率分别为9.0%和19.1%,与对照组比较差异有统计学意义(P<0.05)。GAD-Ab和ICA抗体阳性患者C肽水平较低。结论GAD-Ab、ICA可用于糖尿病的分型诊断,联合检测能提高阳性率,且有助于检出成人隐匿性免疫糖尿病(LADA)。

Objective To evaluate the diagnostic values of combining detection of serum glutamie acid decarboxylase antibody （GAD-Ab） and islet cell antibody（ICA.） in diabetes typing. Methods The blood samples of 138 patients diagnosed clinically as diabetes mellitus and 38 health individuals were taken to measure GAD-Ab and ICA by the methods of RIA arid ELISA respectively. Results The positive rate of GAD-Ab and ICA in the patients with type 1 diabetes was 57.1% and 38.8% respectively, joint testing positive rate was 91.8%, and there were significant difference compared to other groups（ P 〈 0.01 ）. The positive rate of GAD-Ab and ICA in the patients with type2 diabetes was 9.0% and 19.1% ,and there was significant difference compared to control group（P 〈0.05）. The serum C peptide levels in the patients with positive antibodies was lower than that of those with negative antibodies. Conclusions GAD-Ab and ICA can be used to the typing diagnosis of diabetes,and the joint detection can improve the positive rate and help to detect latent autoimmune diabetes adults（LADA）.