4种自身抗体联合检测对1型糖尿病诊断的意义

Significance of combined determination with four autoantibodies in diagnosis of type 1 diabetes

目的探讨联合检测谷氨酸脱羧酶抗体(GADA)、蛋白质酪氨酸磷酸酶抗体(IA-2A)、锌转运体8抗体(Zn T8A)和胰岛特异的葡萄糖-6-磷酸酶催化亚基相关蛋白抗体(IGRPA)对1型糖尿病患者诊断的意义。方法采用酶联免疫吸附法(ELISA)对45例1型糖尿病患者、50例2型糖尿病患者及50例正常对照者血清进行GADA、IA-2A、Zn T8A及IGRPA自身抗体的检测。结果 IA-2A、GADA、Zn T8A和IGRPA在1型糖尿病患者中检出率分别为28.89%、53.33%、71.11%和77.78%。4种自身抗体的阳性率在1型糖尿病患者中高于2型糖尿病组及正常对照组,差异有统计学意义(P<0.05)。自身抗体联合检测敏感度均高于单项组,GADA/IA-2A/Zn T8A/IGRPA 4项联合检测敏感度及曲线下面积(AUC)均为最高,分别为95.56%和0.988。结论 GADA、IA-2A、Zn T8A和IGRPA抗体的联合检测可以显著提高1型糖尿病的检出率,对1型糖尿病的诊断具有重要意义。

Objective To explore the significance of the combined determination of glutamic acid decarboxylase antibody（ GADA）,insulinoma-associated 2 molecule antibody（ IA-2 A） and Zinc transporter 8 antibody and Islet-specific glucose-6-phosphatase catalytic subunit-related protein autoantibody（ IGRPA） in the diagnosis of type 1 diabetes. Methods GADA,IA-2 A,Zn T8 A and IGRPA autoantibody in serum were conducted for detection by enzyme-linked immunosorbent assay（ ELISA） in 45 patients with type 1 diabetes mellitus,50 type 2 diabetic patients and 50 normal controls. Results The detection rates of IA-2 A,GADA,Zn T8 A and IGRPA in patients with type 1 diabetes were 28. 89%,53. 33%,71. 11% and77. 78%. The positive rate of four autoantibodies in type 1 diabetes mellitus was significantly higher than those in type 2 diabetes group and control group,with the differences of statistical significance（ P〈 0. 05）. The sensitivity of the combined autoantibodies detection was higher than that of the single detection. The sensitivity and the area under the curve of GADA/IA-2 A/Zn T8 A/IGRPA were 95. 56% and 0. 988,respectively. Conclusion The combined detection of GADA,IA-2 A,Zn T8 A and IGRPA can significantly improve the detection rate of type 1 diabetes mellitus,and has important significance for the diagnosis of type 1 diabetes mellitus.