糖尿病患者谷氨酸脱羧酶抗体测定的价值

Value of detection of glutamic acid decarboxylase antibodies in patients with diabetes mellitus

目的探讨糖尿病患者谷氨酸脱羧酶抗体（GAD—Ab）的检出率及其对糖尿病分型的诊断价值。方法采用酶联免疫法检测98例糖尿病患者、20例正常对照者血谷氨酸脱羧酶的抗体水平，统计T。DM组、T2DM非肥胖组、％DM肥胖组、正常对照组共4组研究对象的谷氨酸脱羧酶抗体的检出率，比较每种抗体各组间的阳性率，另外比较两种抗体同时阳性的比率。结果①T1DM组、T2DM非肥胖组、T2DM肥胖组GAD—Ab检出率分别为70．0％、6．3％和5．6％；ICA检出率分别为68％、8．8％、7．2％；GAD—Ab和ICA同时阳性的几率为68％。②糖尿病各组的检出率分别与正常组比较，P〈0．01，差异有显著性。③T-DM组的检出率分别与T2DM两组比较．均P〈0．05，差异有统计学意义。④T2DM两组问检出率比较，P〉0．05，差异无统计学意义。结论GAD—Ah是1型糖尿病自然病程中B细胞功能损伤的一个指标，对糖尿病预测、分型、指导治疗、判断预后等具有一定的意义。

Objective To investigate the detection rate of glutamic acid decarboxylase （ GAD ） antibodies in patients with diabetes and the diagnostic value of the rate for typing diabetes. Methods Levels of GAD antibodies were detected in 98 patients with diabetes and 20 healthy controls by enzyme- linked immunosorbent assay. The detection rate was documented in group with T1DM, non-obesity group with T2DM, obesity group with T2DM, and control group. The positive rate of GAD-Ab or ICA was compared among the four group and the GAD-Ab and ICA co-positive rate was also compared. Results The detection rate of GAD-Ab was 70.0% in the group with T1DM, 6.3% in the non-obesity group with TzDM, 5.6% in the obesity group with TzDM; and that of ICA was 68%, 8.8%, and 7.2%, respectively. The detection rate differed significantly between the groups with diabetes and the control group （ P〈 0.01 ） and between the group with T^DM and the two groups with T2DM （ P 〈 0.05 ）; while it did not differ significantly between the non-obesity group with TzDM and the obesity group with T2DM （ P 〉 0.05 ）. Conclusions Glutamic acid decarboxylase antibody is a marker of 13-cell dysfunction in the natural course of type 1 diabetes mellitus. It is of significance in predicting, typing and treating diabetes mellitus, and estimating prognosis.