血清GAD、ICA及C-P联合检测对I型糖尿病的诊断价值

Diagnostic Value of Combined Detection of Serum GAD,ICA and C-P in Type I Diabetes Mellitus

目的探讨I型糖尿病(type 1 diabetes mellitus,T1DM)患者血清谷胱氨酸脱羧酶抗体(glutamic acid decarboxylase antibody,GAD)、胰岛细胞自身抗体(islet cell autoantibody,ICA)、C肽(C-peptide,C-P)水平变化对T1DM患者的临床诊断价值。方法回顾性分析楚雄彝族自治州人民医院2019年1月至2020年8月期间54例T1DM确诊患者检测的GAD、ICA、C-P数值,同时与在此期间来我院体检的50例正常人群进行分析对比。结果观察组GAD、ICA明显高于对照组;观察组C-P明显低于对照组,差异有统计学意义(P<0.05)。GAD、ICA、C-P及3项共同检测用于T1DM诊断的AUC分别为0.927、0.840、0.956、0.993。其中GAD、ICA、C-P共同检测的ROC曲线下面积(AUC)最大,提示GAD、ICA、C-P联合检测的诊断效能高于GAD、ICA、CP单独检测。结论GAD、ICA及C-P指标联合检测有利于提高T1DM诊断的灵敏度和特异度,对于T1DM的临床早期诊疗及预防预警评估具有突出作用。

Objective To explore the diagnostic value of glutamic acid decarboxylase antibody(GAD),islet cell autoantibody(ICA)and C-Peptide(C-P)detection in Type I diabetes mellitus.Methods GAD,ICA and C-P values of 54 T1DM confirmed patients in People’s Hospital of Chuxiong Yi Autonomous Prefecture from January 2019 to August 2020 were analyzed retrospectively,and compared with 50 normal people who came to our hospital for physical examination during this period.Results GAD and ICA in observation group were significantly higher than those in control group.The C-P of observation group was significantly lower than that of control group,and the difference was statistically significant(P<0.05).The AUC of GAD,ICA,C-P and three combined tests for T1DM diagnosis were 0.927,0.840,0.956 and 0.993,respectively.The area under ROC curve(AUC)of GAD,ICA and C-P combined detection was the largest,suggesting that the diagnostic efficiency of GAD,ICA and C-P combined detection was higher than that of GAD,ICA and C-P alone.Conclusion The combined detection of GAD,ICA and C-P can improve the sensitivity and specificity of T1DM diagnosis,and play an outstanding role in the early diagnosis,treatment,prevention and early warning evaluation of T1DM.