Graves病及1型糖尿病患者促甲状腺激素受体抗体、锌转运体8抗体及谷氨酸脱羧酶抗体表达水平比较

Serum level of thyroid-stimulating hormone receptor antibody, zinc transporter 8 antibody and glutamic acid decarboxylase antibody in patients with Graves＇ disease or type 1 diabetes mellitus

目的探讨Graves病患者促甲状腺激素受体抗体、锌转运体8抗体、谷氨酸脱羧酶抗体水平及其相关性。方法招募2009年11月至2011年3月吉林大学白求恩第二医院内分泌科门诊和病房收治的51例Graves病患者（Graves病组；男9例，女42例）及72例1型糖尿病患者（1型糖尿病组；男30例，女42例），另以70名志愿者为健康对照组。利用放射免疫分析法检测各组血清促甲状腺激素受体抗体水平，采用放射免疫沉淀法检测锌转运体8抗体及谷氨酸脱羧酶抗体水平。Pearson相关分析进行组问相关性分析。结果Graves病组促甲状腺激素受体抗体、锌转运体8抗体、谷氨酸脱羧酶抗体的阳性率分别为90．2％（46／51）、15．7％（8／51）和5．9％（3／51），1型糖尿病组上述3种抗体的阳性率依次为4．2％（3／72）、45．8％（33／72）和41．7％（30／72），健康对照组上述3种抗体的阳性率依次为0、1．4％（1／70）和1．4％（1／70）。Graves病组促甲状腺激素受体抗体与锌转运体8抗体呈正线性相关（r=0．278，P〈0．05）；促甲状腺激素受体抗体阳性的Graves病患者促甲状腺激素受体抗体与锌转运体8抗体呈正线性相关（r=0．537，P〈0．01）。1型糖尿病组锌转运体8抗体与谷氨酸脱羧酶抗体呈明显正线性相关（r=0．892，P〈0．01）。结论自身免疫性甲状腺病与自身免疫性糖尿病可能存在一定关联。1型糖尿病患者锌转运体8抗体水平与谷氨酸脱羧酶抗体水平高度相关。

Objective To investigate the relationship between thyroid-stimulating hormone receptor antibody （TRAb）, zinc transporter 8 antibody （ZnT8A） and glutamic acid decarboxylase antibody （GADA） in patients with Graves＇ disease （GD）. Methods A total of 51 GD patients （9 male, 42 female） and 72 type 1 diabetes mellitus （T1DM） patients （30 male, 42 female） were collected from outpatient and inpatient department of our hospital from November 2009 to March 2011, and 70 healthy volunteers （29 male, 41 female）were recruited as control group. The serum levels of TRAb, ZnT8A and GADA were detected by radioimmunoprecipitation and radioimmunoassay methods, respectively. Pearson＇ s correlation coefficient was used to evaluate the correlation between the autoantibodies. Results The positive rate of TRAb, ZnTSA and GADA in the GD group was 90. 2% （46/51）, 15.7% （8/51） and 5.9% （3/51）, respectively. The positive rate of TRAb, ZnTSA and GADA in the T1DM group was 4. 2% （3/72）, 45.8% （33/72） and 41.7% （30/72）, respectively. The positive rate of TRAb, ZnTSA and GADA in the health control group was 0, 1.4% （1/70） and 1.4% （1/70） , respectively. There was a positive correlation between TRAb and ZnT8A in GD patients, and the correlation was even stronger in TRAb positive GD patients （ r = 0. 537, P 〈0. O1 ）. There also showed a strong positive linear correlation between GADA and ZnT8A in T1DM patients （r =0. 892, P 〈 0. 01 ）. Conclusion TRAb may be related with ZnTSA level in GD patients. ZnT8 and TRAb testing may help to diagnose and predict prognosis of GD.