GADab及IA2ab联合检测时诊断1型糖尿病的临床意义

Combined use of GADab and ICA_(512)/IA_2ab in type 1 diabetics

目的探讨GADab和ICA512／IA2ab联合检测在1型糖尿病患者中的检出率及其对1型糖尿病诊断的意义。方法用放免法测定22例1型糖尿病血清GADab和ICA512／IA2ab滴度及C肽水平。结果22例患者中有10例GADab阳性（滴度大于5者为阳性），阳性率为45．45％，1例ICA512／IA2ab阳性（滴度大于3者为阳性），阳性率为4．55％，但是其滴度高达61，相应的GADab滴度也高达55。相关性分析表明，空腹C肽与餐后C肽显著相关，r＝0．61，P＜0．01；年龄和病程明显相关，r=0．53，P＜0．05。GADab阳性组与阴性组的比较：在22例1型糖尿病患者中，GADab阳性组发病年龄更轻，井有更低的餐后C肽水平（P＜0．05）。结论GADab在1型糖尿病血清中有较高的阳性率且较为稳定持久，可用做1型糖尿病诊断的指标，对于糖尿病分型及阐明1型糖尿病的发病机理有积极的意义，从2型糖尿病及早筛选出LADA，为临床及早应用胰岛素治疗1型糖尿病和LADA以保护残存的胰岛β细胞功能提供依据。而联合测定GADab和ICA512／IA2ab可提高1型糖尿病的检出率。

Objective To stydy the ratio of positive about GADab and ICA,,,/IA,ab in patients with type 1diabetics and the significance for the diagnosis. Methods Using the RIA to measure the titre of GADab and ICA512/IAZab and the level of c-peptide in serum. Results There was 10 GADab positive (titre>5)in 22 patients with IDDM(45. 45N),and onyl I ICA,,,/IA,ab positive (titreM3) in 22 IDDM (4. 55%),but his titre up to 61 and the trire ofGADab up to 55. The relative analysis showed that fasting c--peptide was significantly related to postprandial c--peptider = 0. 61, P <0. of),and age was significantly related to duration(r~ 0. 53, P <0. 05). Compated with GADab negativeGADab positive of IDDM were younger and had lower postprandial c-peptide (P CO. 05). Conclusion GADab is stableand lasting,it can be used for the reliable immunologic marker of diagnosis for IDDM,so we can screen out LADA fromNIDDM and treat them with insulin as soon as possible to protect the remaining &cell ipa islet of langerhans. Combiningthe measure of GADab and ICA512/IAZab can increase the ratio of positive in IDDM.