老年糖尿病患者血清GAD-Ab、ICA、IAA和IA-2-Ab联合检测的临床应用价值

Clinical Value of Combined Detection of GAD-Ab, ICA, IAA and IA-2-Ab in Elderly Patientswith Diabetes Mellitus

[目的]探讨谷氨酸脱羧酶抗体（GAD-Ab）、胰岛细胞抗体（ICA）、胰岛自身抗体（IAA）和蛋白酪氨酸磷酸酶抗体（IA-2-Ab）联合检测对老年糖尿病患者的应用价值.[方法]采用免疫印迹法检测330例老年糖尿病患者和40例正常人血清中GAD-Ab、ICA、IAA和IA-2-Ab,并对四项自身抗体全阴患者与有一项以上阳性患者的空腹血糖（FBG）、餐后两小时血糖（2hPBG）和糖化血红蛋白（HbA1c）等血液生化指标进行比较.[结果]430例老年糖尿病患者GAD-Ab、ICA、IAA和IA-2-Ab的阳性率分别为39.7%、28.5%、17.0%和16.4%,四项自身抗体全阴患者124例,占37.6%,与有一项以上阳性患者比较,其FPG、2hPBG和HbA1c水平无显著差异（P〉0.05）.

[Objective] To explore the value of combined detection of glutamic acid decarboxylase antibody（GAD-Ab）, islet cell antibody（ICA）, insulin autoantibody （IAA） and protein-tyrosine phosphatase antibody （IA-2-Ab） in elderly patients with diabetes mellitus（DM）. [Methods] Western blotting was used to detect serum GAD-Ab, ICA, IAA and IA-2-Ab in 430 elderly patients with DM and 40 healthy people. Biochemical indicators such as fasting plasma glucose（FPG）, postprandial 2h-blood glueose（PBG） and HbAlc were compared between patients with all 4 negative autoantibodies and patients with one or more positive autoantibodies. [Results]The positive rate of GAD-Ab, ICA, IAA and IA-2-Ab in 430 elderly patients with DM was 39. 7 %, 28.5%, 17.0% and 16.4%, respectively. There were 124 patients（37.6%） with all 4 negative autoantibodies. There was no difference in FPG, PBG and HbAlc between patients with all 4 negative autoantibodies and patients with one or more positive autoantibodies. [Conclusion] The combined detection of GADAb, ICA, IAA and IA-2-Ab in serum have the important significance for the diagnosis and treatment protocol of elderly patients with DM.