46个家庭家族聚集性糖尿病胰岛细胞抗体分析及3年观察

Analysis of Islet Cell Antibody of 46 Families with Family Aggregation Diabetes

目的对46个家庭171例糖尿病患者的183例未发糖尿病的同胞进行胰岛细胞抗体,胰岛β细胞功能和糖代谢的检测。以观察糖尿病特别是LADA患者的家族聚集性和胰岛细胞抗体在LADA发病中的预测性。方法对家族同胞中有2例或2例以上先证糖尿病患者检测其及其他同胞的胰岛细胞抗体(GADA、ICA、IA-2A和IAA)。胰岛细胞功能(空腹,标准餐负荷后2小时血糖和C肽)以及BMI,腰/臀比。观察:①家族集聚性糖尿病患者胰岛细胞抗体阳性率;②未发病同胞中胰岛细胞阳性率,胰岛细胞功能,3年中家族同胞中新发糖尿病的概率。结果①家族集聚性糖尿病患者同胞中胰岛细胞抗体较一般人群相比高,差异具有统计学意义(P<0.05);②IFG、IGT异常者多,与一般人群相比,差异具有统计学意义(P<0.05);③进展为LADA的比例高,与一般人群发病率相比差异具有统计学意义(P<0.05);④BMI,腰/臀比低于一般2型糖尿病患者,差别无统计学意义。结论 LADA具有家族聚集性,LADA患者的家族同胞中胰岛细胞抗体阳性率高于一般人群,IFG、IGT以及糖尿病的发生率高于一般人群。

Objective To observe the family aggregation of the diabetes especially latent autoimmune diabetes in adults（LADA） and the predictive effect of islet cell antibody in LADA by testing the islet cell antibody,islet cell function and glycometabolism of 183 siblings without diabetes of 171 diabetics in 46 families.Methods For the families with two or more diabetics in siblings,the islet cell antibodies（GADA,ICA,IA-2A and IAA）,islet cell function（fasting and postprandial blood glucose level,C-peptide level）,body mass index（BMI） and waist hip ratio（WHR） were tested in all probands and their siblings.The positive rate of islet cell antibody and islet cell function in the patients with family aggregation diabetes and their siblings,and the probability of new diabetics after 3 years in these families were observed.Results ①The positive rate of islet cell antibody in the siblings of patients with family aggregation diabetes was higher as compared to that of general populations,and the statistical significance difference was found（P0.05）;②The rate of impaired fasting glucose（IFG） and impaired glucose tolerance（IGT） were higher than that of normal people（P0.05）;③The risk of LADA in siblings was higher as compared with normal people（P0.05）;④There was no significant difference in BMI and WHR between the siblings and general type 2 diabetics.Conclusion LADA showed high family aggregation,and the positive rate of islet cell antibody and the incidence of IGT,IFG and diabetes in siblings of patients with LADA was higher than that of general population.