1型糖尿病患者胰岛自身抗体与肾损害的相关性

Relationship Between Renal Injury and Islet Autoantibodies in Type 1 Diabetic Patients

目的:探讨1型糖尿病患者胰岛自身抗体与早期肾损害的相关性。方法:将133例1型糖尿病患者按尿白蛋白排泄率分成正常白蛋白尿组(NAU),微量白蛋白尿组(MAU)和临床蛋白尿组(CAU),测定空腹血糖、空腹胰岛素,24h尿微量白蛋白;谷氨酸脱羧酶抗体(GADA),胰岛素抗体(IAA)和胰岛细胞抗体(ICA);计算胰岛素抵抗指数(Homa-IR)和胰岛素敏感指数(ISI),分析胰岛自身抗体与早期肾损害的关系。结果:NAU组GADA,ICA和IAA的阳性率显著低于CAU组和MAU组;CAU组FINs、HOMA-IR明显高于NAU和MAU组,ISI低于NAU组和MAU,P<0.05。UAER与HOMA-IR呈正相关,与ISI呈负相关(P<0.05)。结论:胰岛自身抗体阳性是发生糖尿病肾病的一个危险信号,胰岛素抵抗在其发生发展的过程中起重要作用。

Objective：To explore the relationship between renal injury and islet autoantibodies in type 1 diabetic patients.Methods：Total 133 patients with type 1 diabetes mellitus were divided into 3 groups：urine albumin excretion ratio （UAER）30 mg/d,30 mg/dUAER300 mg/d and UAER300 mg/d,fasting blood sugar （FBS）,fasting serum insulin （FINS）,urea nitrogen,creatinine,UAER,glutamic acid decarboxylase antibody（GADA）,islet cell antibody （ICA） and insulin autoantibody（IAA）were observed and HOMA insulin secretion index （HOMA-IR） and insulin sensitivity index （ISI） were calculated.Results：Significant differences were showed in the positive rate of GADA、ICA and IAA;FINs、HOMA-IR and ISI between the three groups（P0.05）.UAER was significantly correlated wih HOMA-IR and ISI.Conclusion：The positive rate of islet autoantibodies is one of the danger signal of renal injury in type 1 diabetes mellitus,and insulin resistance should not be neglected in occurrence and development of diabetic nephropathy.