联合检测血清GAD-Ab、ICA和IAA在糖尿病分型诊断中的应用价值

The Value of Combined Detection of Serum GAD-Ab,ICA and IAA in the Diagnosis of Diabetes

目的探究血清谷氨酸脱羧酶抗体(GAD-Ab)、胰岛细胞抗体(ICA)和胰岛素自身抗体(IAA)联合检测对糖尿病(DM)分型诊断的临床应用价值。方法筛选2016年1月至2017年3月来宁夏医科大学总医院心脑血管病医院就诊的内分泌及门诊糖尿病病人160例,其中诊断为T1DM和T2DM患者各80例,选择健康体检血脂、血糖正常者40例作为对照组。均应用MAGLUMI-4000全自动免疫分析仪检测血清GAD-Ab、ICA和IAA水平。采用受试者工作特征(ROC)曲线评价各指标的敏感性和特异性。结果T1DM组的GAD-Ab、ICA和IAA阳性率和水平均高于T2DM组和健康对照组(P均<0.05),三项检测指标中GAD-Ab的阳性率最高(69.42%)。GAD-Ab、ICA和IAA的联合检测阳性率高于T1DM组(93.49%),GAD-Ab、ICA、IAA的ROC曲线下面积分别是0.77496、0.66496、0.69006,联合检测的ROC曲线下面积0.80780。结论血清GAD-Ab、ICA和IAA联合检测,能够提高诊断T1DM的准确率,对于糖尿病的早期诊断和治疗具有参考价值。

Objective To explore the serum glutamic acid decarboxylase antibody(GAD-Ab)and islet cell antibody(ICA)and insulin autoantibodies(IAA)joint detection of diabetes diagnosis and classification of the clinical application value.Methods From January 2016 to March 2017,160 patients with endocrine and outpatient diabetes were screened,80 of them were diagnosed as T1 DM and T2 DM respectively,and 40 of them were selected as the control group.The levels of GAD AB,ICA and IAA were measured by maglumi-4000 automatic immunoanalyzer.The receiver operating characteristic(ROC)curve was used to evaluate the sensitivity and specificity of each index.Results The positive rates and levels of GAD AB,ICA and IAA in T1 DM group were higher than those in T2 DM group and healthy control group(P all<0.05),and the highest positive rate of GAD AB was 69.42%.The positive rate of GAD AB,ICA and IAA was higher than that of T1 DM group(93.49%).The area under the working characteristic curve of GAD AB,ICA and IAA was0.77493,0.66496 and 0.69006 respectively,and the area under the ROC curve of joint detection was0.80780.Conclusion The single detection of serum GAD AB,ICA and IAA has little value in the early diagnosis of diabetes.The combined detection is an ideal combination of diabetes classification,which can improve the accuracy of DM1 diagnosis,and has reference value for the early diagnosis and treatment of diabetes.