1型糖尿病患者血清免疫球蛋白G4水平变化及其临床意义

The level changes of serum immunoglobulin G4 in Type 1 diabetes patients,and their clinical significance

目的探讨1型糖尿病患者血清免疫球蛋白G4(IgG4)水平的变化及临床意义。方法应用酶联免疫法(ELISA)对已确诊的1型糖尿病患者血清IgG4进行检测,以健康人及2型糖尿病患者作为对照组进行统计分析,根据血清IgG4水平将患者分为IgG4组(≥0.63g/L)及非IgG4组(<0.63g/L),结合患者临床资料、实验室资料,分别比较1型糖尿病组与对照组IgG4的表达水平及1型糖尿病组内IgG4表达水平的不同,分析其临床特点。结果1型糖尿病组血清IgG4水平高于2型糖尿病组及健康对照组,差异有统计学意义(P=0.01及P=0.00)。1型糖尿病组组内比较,可见IgG4组患者年龄较非IgG4组小(P=0.04),起病年龄亦小于非IgG4组(P=0.03),尿蛋白阳性率高于非IgG4组(P=0.01)。结论1型糖尿病患者血清IgG4水平高于2型糖尿病患者及健康人;血清IgG4水平明显升高的1型糖尿病患者起病年龄更早,且更易出现肾脏损害。

Objective To explore whether the differences of serum IgG4 level in Type 1 diabetes patients were associated with different clinical features.Methods ELISA was employed to detect the serum level of IgG4 in diagnosed T1D patients.These T1D patients were divided into IgG4 group(≥0.63g/L)and non-IgG4 group(<0.63g/L)accordingly and healthy individuals and T2D patients were used as control groups.Meanwhile,the clinic profiles,lab profiles were reviewed respectively to compare the differences between T1D group and control groups,and to analyze the correlation between different serum level of IgG4 in T1D group and their clinical features.Results The serum level of IgG4 in T1D patients was significantly higher than that of T2D group(P=0.01)and health control group(P=0.00).Comparing the IgG4 levels between subgroups of T1D patients,showed the patients in IgG4 group was younger(P=0.04),and had earlier onset of disease than that of non-IgG4 group(P=0.03).Compared with non-IgG4 group,the patients of IgG4 group had significantly higher positive rate of glutamic acid decarboxylase antibody(P=0.04)and urine protein(P=0.01).Conclusion The serum levels of IgG4 in T1D patients are higher significantly than that of T2D patients and healthy individual.T1D patients who have higher serum levels of IgG4 are younger,have higher positive rate of autoantibody and are more likely to have renal damage.