ZnT-8A对成人隐匿性免疫性糖尿病诊断价值的初步研究

Preliminary study on the diagnostic value of ZnT-8A in adult occult immune diabetes

目的探究锌转运体8自身抗体(Zn T-8A)对成人隐匿性免疫性糖尿病(LADA)的诊断价值。方法回顾性分析2017年5月至2018年4月大理大学第一附属医院收治的160例初诊为糖尿病的患者,根据糖尿病分型将患者分为A组(T1DM非LADA,n=60)、B组(T2DM,n=69)、C组(LADA,n=31)。对比三组常规胰岛自身抗体和Zn T-8A阳性率及联合检测阳性率、三组Zn T-8A阳性率、C组各胰岛自身抗体阳性率。结果C组患者的血清GADN、IAA、IA-2A、ICA、Zn T-8A抗体阳性率分别为41.9%、25.8%、22.6%、16.1%、61.3%,均分别高于A组的11.7%、6.7%、10.0%、6.7%、13.3%(P<0.05)及B组的10.1%、7.2%、8.7%、7.2%、8.7%(P<0.05)。C组患者的ZnT-8A抗体阳性率为61.3%,分别高于A组的13.3%、B组的8.7%(P<0.05)。C组的ZnT-8A抗体阳性率最高,与其他胰岛自身抗体比较差异具有统计学意义(P<0.05)。C组5种胰岛自身抗体联合检测阳性率为93.5%,分别高于A组的23.3%、B组的18.8%,三组比较差异均具有统计学意义(P<0.05)。结论常规胰岛自身抗体联合Zn T-8A抗体检测有助于进一步诊断LADA,且相较于常规抗体,Zn T-8A抗体阳性率更高,对临床后续治疗有重要的指导意义。

Objective To explore the diagnostic significance of zinc transporter 8 autoantibodies(ZnT-8 A)in adults with occult immune diabetes.Methods Retrospective analysis of 160 patients with newly diagnosed diabetes admitted to First Affiliated Hospital of Dali University during May 2017 to April 2018 had been carried,according to the classification of diabetes,they were divided into group A(T1 DM no LADA,n=60),group B(T2 DM,n=69),group C(LADA,n=31),compare these three groups of conventional islet autoantibodies and ZnT-8 A positive rate,positive rate and united detection of ZnT-8 A positive rate,C group each islet autoantibodies in C group were positive.Results The positive rate of serum GADN,IAA,IA-2 A,ICA,ZnT-8 A in group C was 41.9%,25.8%,22.6%,16.1%and 61.3%,respectively,higher than that in group A(11.7%,6.7%,10.0%,6.7%,13.3%(P<0.05)and that in group B(10.1%,7.2%,8.7%,7.2%,8.7%,8.7%).The positive rate of ZnT-8 A antibody was 61.3%in group C,higher than 13.3%in group A and 8.7%in group B(P<0.05).The positive rate of ZnT-8 A antibody was highest in group C,and the difference was statistically significant compared with other islet autoantibodies(P<0.05).The combined positive rate of group C was 93.5%,which was higher than 23.3%of group A and 18.8%of group B,and the difference was statistically significant(P<0.05).Conclusion Conventional islet autoantibodies combined with ZnT-8 A antibody test are helpful for further diagnosis of LADA,and the positive rate is the highest compared with conventional antibodies,which is of great significance for clinical follow-up treatment.