自身抗体在成人隐匿性自身免疫性糖尿病中的诊断价值

Diagnostic Value of the Autoantibodies In the Latent Autoimmune Diabetes Mellitus in Adults

目的探讨谷氨酸脱羧酶抗体(GAD-Ab)、胰岛细胞抗体(ICA)、胰岛素自身抗体(IAA)在成人隐匿性自身免疫性糖尿病(LADA)早期诊断中的临床价值。方法用ELISA法测定188例2型糖尿病患者的谷氨酸脱羧酶抗体(GAD-Ab)、胰岛细胞抗体(ICA)、胰岛素自身抗体(IAA),并对检出任一抗体的抗体阳性组与未检出抗体的抗体阴性组的临床特征进行比较。结果188例2型糖尿病患者中共检出抗体阳性病例56例,且抗体阳性的糖尿病患者在体重指数(BMI)、发病年龄、病程、空腹和餐后2h平均C肽值均低于阴性组,差异有统计学意义(P<0.05);且抗体阳性组自发酮症的例数也高于抗体阴性组。两组年龄及血糖值差异无统计学意义(P>0.05)。结论谷氨酸脱羧酶抗体,胰岛细胞抗体和胰岛素自身抗体对疑似2型糖尿病(DM2)的LADA患者的早期诊断具有重要的临床意义。

Objective To explore the diagnostic values of detection of glutamic acid decarboxylase antibody（ GAD-Ab ）, isletcell antibody （ICA）and insulin autoantibody（IAA） in patients with early stage latent autoimmune diabetes mellitus in adulls（LADA）. Methods 188 pa- tients of type 2 diabetes mellitus（T2DM ） Serum GAD-Ab, ICA and IAA were examined by the ELISA method in, and as well clinical feature was compared between antibody positive group and antibody negative group. Results 56 cases in 188 patients with T2DM are antoantibody positive. And the diabetic of the antibody masculine gender is in the BMI,the outbreak age. Course of illness,the empty stomach and after meal 2h the average C-pcptide of antibody positve group were all lower than those of antibody negative group significantly. The difference has statistical significance （P 〈 0.05 ）. Differentce of the age and blood sugar value of two groups has no statistical significance （P 〉 0.05 ）. Conclusion The GAD-Ab,ICA and IAA have important meaning for early diagnosis of the LADA sufferer.