糖尿病患者血清GAD-Ab、ICA、IAA联合检测的临床意义

Clinical meaning which diabetic serum GAD-Ab, ICA, IAA jointly measures

[目的 ]探讨糖尿病患者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)的联合检测在临床中的重要意义。 [方法 ]用ELISA法测定 4 3例 1型糖尿病 (ID DM )患者、5 5例 2型糖尿病 (NIDDM )患者和 5 0例正常人血清中的GAD -Ab、ICA、IAA。 [结果 ]1型糖尿病组中GAD -Ab、ICA、IAA的阳性率分别为 76 .7%、37.2 %、2 5 .6 % ;2型糖尿病组中 3种抗体的阳性率分别为 9.1 %、1 0 .9%、1 0 .9% ;正常对照组中GAD -Ab、ICA、IAA均为阴性。 1型糖尿病患者的GAD -Ab、ICA、IAA阳性率都高于 2型糖尿病患者 (P <0 .0 5 )及正常对照组 (P<0 .0 5 )。 [结论 ](1 )测定GAD -Ab在糖尿病分型及预测中优于ICA和IAA。 (2 )GAD -Ab、ICA、IAA的联合检测是鉴别 1型糖尿病和 2型糖尿病的重要血清学指标。 (3)在预测 1型糖尿病发病及早期诊断中 ,GAD -Ab、ICA、IAA的联合检测可提高检出阳性率 ,避免漏诊 。

Objective] To explore the value of combined detection of GAD-Ab、ICA and IAA in serum of diabetes mellitus patients .[Methods] The authors measured GAD-Ab, ICA, IAA in serum of 43 patients of type 1 diabetes(IDDM), 55 patients of type 2 diabetes( NIDDM) and 50 normal persons with ELISA.[Results] The positive rate of GAD-Ab is 76.7%, ICA is 37.2%, IAA is 25.6% in the diabetes group of type 1; the positive rate of GAD-Ab is 9.1%, ICA is 10.9%, IAA is 10.9% in the diabetes group of type 2; but GAD-Ab, ICA, IAA are negative in the normal group. [Conclusions] (1)GAD-Ab positive rate of the diabetic of type 1 is higher than ICA 、IAA obviously. The authors suggest that detection of GAD-Ab is superior to ICA、IAA in classification and prognostication of diabetes. (2) The positive rates of GAD-Ab、ICA 、IAA in type 1 diabetes are higher than type 2 diabetes and normal group( the P value is <0.05). The authors suggest that the combined detection of GAD-Ab、ICA and IAA is a important serological index to distinguish the type 1 and type 2 diabetes.(3) The combined detection of GAD-Ab, ICA, IAA can improve the positive rate , avoid leaking rate,and improved the specification and sensitivity in the early diagnosis of diabetes, and can pick out the endanger crowds.