谷氨酸脱羧酶抗体滴度与糖尿病患者胰岛功能关系的研究

Study of relationship between glutamic acid decarboxylase antibody titers and islet function of patients with diabetes

目的探讨谷氨酸脱羧酶抗体(GAD-Ab)与糖尿病胰岛功能的关系及对胰岛功能衰减速度的影响。方法对比137例糖尿病患者的胰岛功能检查及谷氨酸脱羧酶抗体(GAD-Ab)筛查,比较谷氨酸脱羧酶抗体(GAD-Ab)阳性组12例与阴性组125例的发病年龄、体重指数、胰岛功能-C肽及糖化血红蛋白等指标,并进行1年追踪随访。结果①GAD-Ab阳性组发病年龄、体重指数明显低于阴性组(P<0.01);②空腹及餐后2 h C肽值较阴性组低(P<0.01),糖化血红蛋白(HbA1C)明显高于阴性组(P<0.01);③1年内GAD-Ab阳性者胰岛功能衰减明显,并与GAD-Ab滴度、发病年龄、体重指数及用药密切相关。结论对糖尿病患者进行GAD-Ab检测,能预测胰岛细胞损伤进展情况,有利于协助糖尿病的确切分型,对于GADA阳性者,尽早使用胰岛素强化治疗,可以减轻或延缓自身免疫性胰岛炎的进程,对于改善患者预后具有重要的临床意义。

Objective To explore the glutamic acid decarboxylase antibody （GAD-Ab） relationship with diabetes islet function and the effects on attenuation of islet function. Methods Compared 137 patients with diabetes islet function and glutamic acid decarboxylase antibody （GAD-Ab） screening, comparison of glutamic acid decarboxylase antibody （GAD-Ab） positive group of 12 cases with negative group of onset age, body mass index （bmi）, 125 cases of pancreatic islet function, indexes of c-peptide and glycated hemoglobin, and 1 year of follow-up. Results （1）GAD onset age, body mass index-Ab positive group was obviously lower than negative group （P 〈 0.01）. （2）The fasting and postprandial, 2 h C peptide value was lower than those of negative group （P 〈 0.01）, glycosylated hemoglobin （HbA1C） was significantly higher than negative group （/9 〈 0.01）. （3） One year GAD-Ab positive islet function attenuation, and GAD-Ab drops, onset age, body mass index, and closely related to drug use. Conclusion GAD-Ab detection in patients with diabetes, can predict the progress of the islet cell damage, is conducive to help diabetes segmentation model, indeed for GADA positie, early use of insulin intensive treatment, can reduce or delay the development of autoimmune insulitis, for im- proving the prognosis of patients has important clinical significance.