2型糖尿病患者血清中4种胰岛自身抗体检测的临床意义

Clinical value of 4 islet autoantibodies in type 2 diabetes

目的:探讨2型糖尿病(T2DM)患者血清谷氨酸脱羧酶抗体(GADA)、酪氨酸磷酸酶抗体(IA2)、抗胰岛细胞抗体(ICA)和抗胰岛素抗体(IAA)4种胰岛自身抗体检测的临床价值。方法:对978例T2DM患者和80例正常对照者血清中4种胰岛自身抗体进行检测、比较。结果:GADA、IAA、IA2和ICA在T2DM患者中的阳性率分别为7.1%、7.2%、3.3%和0.5%,联合检测总阳性率为16.0%,明显高于正常对照组3.8%的阳性率。GADA和IA2两种抗体联合检测阳性率为9.2%。T2DM患者中各抗体阳性较少重叠。结论:GADA和IA2两种抗体联合检测对检出T2DM中的成人隐匿性自身免疫性糖尿病(LADA)有重要指导价值,以利于对患者尽快采取有效措施保护胰岛B细胞功能,减少进一步的损伤。

Objective： To explore the value of glutamic acid decarboxylase antibody（GAD-Ab）,protein tyrosine phosphatase antibody-2（IA2）,islet cell antibody（ICA）and insulin autoantibody（IAA）in type 2 diabetes.Methods： GAD-Ab,IA2,ICA and IAA were examined in 978 patients of type 2 diabetes mellitus（T2DM）and 80 normal controls.Results： The positive ratios of GADA,IAA,IA2 and ICA in T2DM were respectively 7.1%,7.2%,3.3% and 0.5%.The positive rate of combined test with the 4 autoantibodies reached to 16.0%,and significantly elevated than that of normal subject（3.8%）.The positive rate of combined test with GAD and IA2 was 9.2%.The positive existence in 4 autoantibodies was seldom overlapping.Conclusion： The Combination of GADA and IA2 examination will help early screen of LADA from type 2 diabetes.For these patients of LADA,early treatment with insulin will dealy the deterioration of pancreatic islet B cell function.