Stiff-Person Syndrome Associated with Anti-Glutamic Acid Decarboxylase Autoimmune Encephalitis in a Young Woman: A Case Report

A 34-year-old female with stiff-person syndrome(SPS)is reported in this paper.She experienced short-term memory impairment and was diagnosed with anti-glutamic add decarboxylase(GAD)autoimmune encephalitis(AE)at the local hospital.However,after the treatment with intravenous immunoglobulin and highdose glucocorticoids,her symptoms unchanged.Two months later,she was admitted to our hospital due to an unstable gait and persistent leg stiffness,at which point she was diagnosed as anti-GAD AE concomitant with SPS.Her clinical symptoms improved with an increased dose of y-aminobutyric acid(GABA)-enhancing drug and plasma exchange.Anti-GAD antibody-associated AE combined with SPS is extremely rare.Treatment with GABA-enhancing drugs and appropriate immunotherapy can improve the neurological function of patients suffering from the combination of SPS and limbic encephalitis.

Autoantibodies related to ataxia and other central nervous system manifestations of gluten enteropathy

Gluten ataxia and other central nervous system disorders could be linked to gluten enteropathy and related autoantibodies.In this narrative review,we focus on the various neuro-logical manifestations in patients with gluten sensitivity/celiac disease,immunological and autoimmune mechanisms of ataxia in connection to gluten sensitivity and the autoantibodies that could be used as a biomarker for diagnosing and following.We focused on the anti-gliadin antibodies,antibodies to different isoforms of tissue transglutaminase(TG)(anti-TG2,3,and 6 antibodies),anti-glycine receptor antibodies,anti-glutamine acid decarboxylase antibodies,anti-deamidated gliadin peptides antibodies,etc.Most studies found a higher prevalence of these antibodies in patients with gluten sensitivity and neurological dysfunction,presented as different neurological disorders.We also discuss the role of a gluten-free diet on the clinical improvement of patients and also on imaging of these disorders.

The role of anti-glutamic acid decarboxylase autoantibodies in mood disorders

Gamma-aminobutyric acid(GABA)possibly plays a causative role in mood disorders.This hypothesis originated with studies on the beneficial effect of valproate in mania and as a mood stabilizer.Since valproate is known for its action in increasing the level of GABA,it was indirectly suggested that decreasing levels of GABA were responsible for mood alterations.To identify factors causing the decreased levels of GABA,studies have concentrated on the activity of the enzyme L-glutamic acid decarboxylase(GAD),which catalyzes the transformation of glutamate to GABA,as a decreasing function of this enzyme induces lower levels of the neurotransmitter.Moreover,a very limited amount of research investigated the possible role of glutamic acid decarboxylase antibodies(GADA)in determining a decreased enzymatic function of GAD.If these findings are confirmed,it will be possible to improve diagnosis and treatment of mood disorders.In addition,if the presence of GADA is associated with a genetic trait,this would allow and facilitate early diagnoses.

Role of C-Peptide in Relation to Levels of Anti-GAD and Islet Cell Antibodies in Characterizing Types of Diabetes in the Young, in Eastern India

Background: Measuring fasting C-peptide (FCP) and antibodies against Glutamic acid decarboxylase (GADA) and Islet cell antibodies (ICA) are not so commonly explored in children and young adults. Objectives: To assess the levels of FCP, GADA and ICA in subjects below the age of 25 years with DM and compare their levels to differentiate between Autoimmune and Non-Autoimmune Type 1 DM. Methodology: Blood samples of 93 subjects diagnosed with DM, reporting to the tertiary care hospital, were analysed for ICA, GADA and FCP. Receiver operating characteristics (ROC) curves were analysed to check the ability of autoimmune markers, BMI and C-peptide to differentiate between Autoimmune (Ai) and Non-Autoimmune (NonAi) diabetes. Results: 30/93 (32.2%) were positive for anti-GAD ab and/or ICA and categorised as Autoimmune (Ai), the most common antibody being, anti-GAD ab (80%) in them. The level of FCP among Ai compared to NonAi, was significantly low (p 20.75 nmol/l) as a very dependable test for diagnosing Ai, Type 1 DM, in children and young adults. Its sensitivity and specificity are in the range of 86.2% and 96.8% respectively. Low level of C-peptide (Conclusion: This study revealed predominant positivity for anti-GAD ab (80%) among Ai+ patients. ROC analysis shows GADA above 20.75 nmol/l and Fasting C-peptide < 0.36 nmol/l as a good indicator for diagnosing Ai in children and young adults.

Diagnostic role of antibodies to glutamic acid decarboxylase in latent autoimmune diabetes mellitus in adults

Objective To investigate the diagnostic role of antibodies to glutamic acid decarboxylase (GAD 65 Ab) in latent autoimmune diabetes of adults (LADA) and the frequency of GAD Ab in Chinese patients initially diagnosed as non insulin dependent diabetes mellitus (NIDDM) Methods Forty five control subjects and 195 consecutive inpatients initially classified as NIDDM with ≥35 years of age at onset and nonketotic history for >6 months after diagnosis, were recruited In vitro transcripted and translated recombinant human 35 S GAD 65 was used in radioligand assay of GAD Ab Results The overall prevalence of GAD 65 Ab was 14 8% (29/195) in NIDDM patients and 2 2% (1/45) in control subjects, respectively Of the 29 GAD 65 Ab positive patients, 17 (58 6%) were insulin deficient while 12 (41 4%) were non insulin deficient The prevalence of GAD 65 Ab in NIDDM group with age of <40 years at diabetes onset, ketotic history, body mass index (BMI) <21 kg/m 2, were significantly higher than that of corresponding control diabetic subgroups (2 5, 4 1 and 3 2 times, respectively) The sex, duration, symptoms of polyphagia, polydipsia, polyuria and weight loss at onset of the disease were not related to the prevalence of GAD 65 Ab positivity Conclusions In China, patients initially diagnosed as NIDDM may in many cases suffer from LADA Testing by GAD 65 Ab may be of assistance to identifying LADA at the earliest stage of disease

The expanding spectrum of pediatric anti-glutamic acid decarboxylase antibody mediated CNS disease-a chance association?

Central nervous system autoimmunity in the pediatric age group represents an evolving constellation of various syndromes distinct from the adult age group.One of the rarely described pathogenic auto-antibodies(ab)is the one directed against glutamic acid decarboxylase(GAD).While its pathogenic role is controversial,literature concerning adult patients abounds with heterogeneous presentations with epilepsy often as part of limbic encephalitis or chronic temporal lobe epilepsy and cerebellar ataxia accompanying endocrinopathies or paraneoplastic disorders.Diagnosis is often delayed until late adulthood.The authors report hitherto under-reported syndromes in the pediatric age group.The first case was a 3-year-old boy with sub-acute myoclonus-ataxia following a flu-like illness akin to para-infectious cerebellitis.The second case was a 7-year-old girl with long-standing chronic extratemporal partial epilepsy and electrical status epilepticus in sleep(ESES)with right hemiparesis and developmental delay.Investigations revealed two-four fold elevations in titres of GAD-65-ab.The absence of systemic diseases like diabetes and the dramatic clinical response to steroids as well as intravenous immunoglobulin in both the cases argued for GAD-ab mediated neuronal injury rather than a chance association.The concern exists regarding other potentially co-existent auto-ab to gamma-amino butyric acid and glycine receptors,and demonstration of intrathecal synthesis of GAD-ab would be ideal.This entity should be contemplated in children presenting with acute/sub-acute onset episodic or progressive ataxia or refractory cryptogenic focal epilepsy syndromes,epileptic encephalopathy such as ESES and worsening neurological deficits.These children ought to be maintained on regular follow-up for monitoring evolution of other autoimmune disorders in adult life.

2型糖尿病患者胰岛细胞自身抗体、抗谷氨酸脱羧酶抗体水平与糖尿病微血管并发症的关系

目的探讨抗胰岛细胞抗体(ICA)、抗胰岛素抗体(IAA)及抗谷氨酸脱羧酶抗体(GADA)与2型糖尿病(T2DM)患者发生糖尿病微血管并发症(DMAP)的关系。方法对2023年11月-2024年3月本院收治的114例T2DM患者临床资料进行回顾性分析,根据是否发生DMAP将患者分别分入单纯T2DM组(n=61)和并发症组(n=53)。检测所有患者入院时IAA、ICA及GADA水平。采用受试者工作特征(ROC)曲线分析IAA、ICA及GADA对DMAP的评估价值,采用多因素logistic回归分析探讨DMAP的影响因素。结果并发症组患者的ICA、IAA、GADA水平均高于单纯T2DM组,差异均有统计学意义(P<0.05)。ICA、IAA及GADA评估T2DM患者发生DMAP的曲线下面积(AUC)分别为0.792、0.736、0.805,联合检测的AUC为0.912。并发症组患者T2DM病程≥8年比例、有饮酒史比例均高于单纯T2DM组患者,差异均有统计学意义(P<0.05)。logistic回归结果显示:T2DM病程≥8年(OR=2.314,95%CI:1.136~4.714)、ICA≥4183.62 RU/mL(OR=4.221,95%CI:1.849~9.633)、IAA≥5587.37 RU/mL(OR=3.449,95%CI:1.654~7.192)、GADA≥3667.92 IU/mL(OR=5.150,95%CI:2.058~12.888)是T2DM患者发生DMAP的危险因素(P<0.05)。结论ICA、IAA及GADA与T2DM患者发生DMAP密切相关,联合检测有助于DMAP的评估。

糖尿病自身免疫抗体联合检测在糖尿病分型中的应用价值

目的分析糖尿病自身免疫抗体联合检测在糖尿病分型中的应用价值。方法将2021年1月—2023年11月于东莞市中医院进行诊治的64例糖尿病患者纳为研究组,其中1型糖尿病(type 1 diabetes mellitus,T1DM)患者22例,2型糖尿病(type 2 diabetes mellitus,T2DM)患者42例。同期体检健康者61例纳为对照组,2组均接受糖尿病自身免疫抗体检测,比较2组的抗体差异性,以及其在糖尿病分型中的价值。结果研究组血清谷氨酸脱羧酶抗体(glutamic acid decarboxylase antibody,GADA)、胰岛细胞抗体(islet cell antibody,ICA)、胰岛素自身抗体(insulin autoantibodies,IAA)以及联合检测阳性率高于对照组,差异有统计学意义(P<0.05);T1DM患者GADA、ICA、IAA以及联合检测阳性率高于T2DM患者,差异有统计学意义(P<0.05);T1DM、T2DM诊断中联合检测的应用价值高于单一抗体检测。结论糖尿病自身免疫抗体联合检测有助于临床更好地鉴别糖尿病分型,为后续治疗提供有价值的指导。

Change of glutamic acid decarboxylase antibody and protein tyrosine phosphatase antibody in Chinese patients with acute-onset type 1 diabetes mellitus

Background Glutamic acid decarboxylase antibody （GADA） and protein tyrosine phosphatase antibody （IA-2A） are two major autoantibodies, which exert important roles in the process of type 1 diabetes mellitus （T1D）. Our study aimed to investigate the changes in positivity and titers of GADA and IA-2A during the course of Chinese acute-onset T1D patients and their relationships with clinical features.

血清GADA、CypA、SIRT1在糖尿病肾病中的表达及早期诊断价值分析

目的:探究血清谷氨酸脱羧酶抗体(Glutamic acid decarboxylase,GADA)、亲环素A(Cyclophilin A,CypA)、Sirtuin-1(SIRT1)在糖尿病肾病(Diabetic nephropathy,DN)中的表达及早期诊断价值。方法:选取2020年1月至2023年1月期间本院收治的81例DN为研究组,另选取同期81例糖尿病患者为对照组。将DN患者根据肾功能损伤程度进一步分为微量蛋白尿组、大量蛋白尿组、肾功能损伤组。比较两组及不同程度肾损伤患者入院时血清GADA、CypA、SIRT1水平及联合诊断价值。结果:研究组血清GADA、CypA水平高于对照组,SIRT1水平低于对照组(P<0.05);不同程度肾损伤患者血清GADA、CypA水平比较:微量蛋白尿组<大量蛋白尿组<肾功能损伤组,SIRT1水平比较:肾功能损伤组<大量蛋白尿组<微量蛋白尿组(P<0.05);入院时血清GADA、CypA、SIRT1水平联合检测糖尿病肾病的AUC为0.840,最佳敏感度、特异度为88.89%、80.25%。结论:血清GADA、CypA、SIRT1水平与DN病情发展密切相关,可作为早期诊断的辅助指标。

谷氨酸脱羧酶抗体和胰岛细胞抗体在IDDM诊断中的价值

用放射免疫法测定７９例胰岛素依赖型糖尿病（ＩＤＤＭ）和５３例非胰岛素依赖型糖尿病（ＮＩＤＤＭ）病人的血清谷氨酸脱羧酶（ＧＡＤ）抗体，用ＥＬＩＳＡ法测定ＩＤＤＭ组的胰岛细胞抗体（ＩＣＡ）和胰岛素抗体（ＩＡＡ）。结果ＩＤＤＭ组ＧＡＤ抗体的阳性率为４６．８％，初发ＩＤＤＭ（病程不超出１年）与病程超出１年的ＧＡＤ抗体阳性率分别是６２．９％和３４．１％。ＮＩＤＤＭ及正常对照组未见阳性的ＧＡＤ抗体。ＩＣＡ和ＩＡＡ阳性率分别为４９．４％、２４．３％。ＧＡＤ和ＩＣＡ两项同时测定的阳性率达７３．７％。提示ＧＡＤ与ＩＣＡ结合使用，可以提高ＩＤＤＭ的检出率。

三种胰岛自身抗体联合检测对1型糖尿病早期诊断的意义

目的:评价联合检测谷氨酸脱羧酶抗体(GADA)、胰岛细胞抗体(ICA)和胰岛素自身抗体(IAA)对1型糖尿病的早期诊断价值。方法:采用酶联免疫吸附法(ELISA)检测GADA、ICA和IAA;电化学发光法检测患者空腹和餐后2h血清C肽。结果:1型糖尿病患者GADA、ICA和IAA阳性率明显高于2型患者和正常组,P<0.001。GADA在1型糖尿病中的阳性检出率明显高于ICA和IAA组,P<0.01。青少年患者组ICA阳性率高于GADA和IAA组,P<0.001,成年组及老年组患者中GADA阳性明显高于ICA和IAA组,P<0.05。GADA/ICA、GADA/IAA及三种抗体联合检测的阳性率,敏感性和诊断符合率均高于单一抗体检测的阳性率,P<0.05。抗体阳性患者的空腹和餐后C肽水平明显低于抗体阴性患者,P<0.01。结论:自身抗体阳性患者的胰岛功能明显低于阴性患者,表明抗体阳性患者胰岛功能有明显损伤。GADA、ICA和IAA联合检测可以提高诊断敏感性和诊断符合率,对1型糖尿病早期诊断具有重要价值,且青少年期GADA和ICA的联合检测显得尤为重要。

Graves病患者血清谷氨酸脱羧酶抗体的变化

目的 研究谷氨酸脱羧酶抗体 (GAD)在 Graves病中的检出及意义。方法 采用酶联免疫法及放射免疫法检测了初发尚未并发糖尿病的 Graves病患者治疗前后及正常对照组的 GAD抗体、抗甲状腺球蛋白抗体(TGA)、抗甲状腺过氧化物酶抗体 (TPOAb)、游离 T3(FT3)、游离 T4 (FT4 )的变化 ,并研究了 GAD抗体与 FT3、FT4 、TGA、TPOAb的关系。结果 GAD抗体与血清 FT3、FT4 水平的相关系数 r分别为 - 0 .36 7(P>0 .0 5 )、0 .0 2 9(P>0 .0 5 ) ,与血清 TGA、TPOAb的相关系数 r分别为 0 .32 0 (P>0 .0 5 )、0 .394 (P>0 .0 5 )。 Graves病治疗前后相比 GAD抗体、TGA、TPOAb、GAD抗体阳性率治疗后有下降趋势但无统计学差异。结论 GAD抗体与 Graves病相关 。

胰岛细胞抗体阳性的成人隐匿性自身免疫糖尿病患者的胰岛β细胞功能

目的 :探讨胰岛细胞抗体 (ICA)和谷氨酸脱羧酶抗体 (GAD Ab)对成人隐匿性自身免疫糖尿病 (LADA)患者胰岛功能的影响和预测价值。方法 :对单独ICA阳性的LADA14例 ,单独GAD Ab阳性的LADA 10例 ,GAD Ab和ICA同时阳性的LADA 7例 ,两抗体均阴性的 2型糖尿病 (T2DM) 2 5例 ,每半年随访一次 (第 2年除外 )直至第 5年 ,测定患者空腹C肽 (FCP)和 10 0g馒头餐后 2hC肽 (2°CP)及糖代谢指标。采用放射免疫法测定GAD Ab和C肽 ,酶联免疫吸附法 (ELISA)测定ICA。结果 :单独GAD Ab阳性和两抗体均阳性组的FCP从随访第 2 .5年开始下降 ,FCP较入组时下降≥ 5 0 %的患者百分比分别从第 3年和第 3.5年升至 6 0 %和 71.4 % ,单独ICA阳性组和抗体阴性的T2DM组则无显著性变化。单独GAD Ab阳性组中 4 / 10例、两抗体均阳性组 1/ 10例出现胰岛功能衰竭 ,前者与单独ICA阳性组 (0 / 14例 )和两抗体均阴性组 (0 / 2 5例 )比较有统计学意义 (均P <0 .0 5 )。ICA与FCP间无显著性相关 (rs= 0 .2 5 8,P <0 .0 5 ) ,多元回归分析显示GAD Ab对FCP的影响远大于ICA。结论 :GAD Ab阳性的LADA患者胰岛 β细胞功能较ICA阳性的LADA以及T2DM下降更快 ,GAD Ab滴度是预测胰岛功能减退速度的重要因素 。

儿童1型糖尿病的抗体检测及临床意义

目的 了解胰岛细胞抗体 (ICA)和谷氨酸脱羧酶抗体 (GADA)阳性率与患儿胰岛功能的关系 ,明确ICA和GADA检测对 1型糖尿病的临床意义。方法 儿童 1型糖尿病 31例均采用ELISA法测定GADA ,间接免疫荧光法测定ICA ,化学发光法测定血清C肽、胰岛素 (DPC -IMMULITE机器 )。结果 ICA和GADA的阳性率分别为 4 5 .2 %和 38.7% ,儿童 1型糖尿病患者ICA阳性率高于GADA。抗体阳性患儿空腹和餐后C肽(0 .99± 0 .36ng/ml和 2 .10± 0 .99ng/ml)及餐后胰岛素 (11.5 3± 7.11μIU/ml)明显低于抗体阴性患儿空腹C肽 (2 .19± 1.33)ng/ml,餐后C肽 (6 .18± 3.91)ng/ml和餐后胰岛素 (18.6 0± 10 .5 9) μIU/ml,P <0 .0 5。结论 青少年糖尿病患者中ICA阳性率高于GADA。自身抗体阳性患儿胰岛功能明显低于阴性患儿 ,提示自身抗体阳性患儿胰岛功能损伤更明显。由于ICA、GADA两种抗体的阳性结果常不一致 。

空腹C-P、INS及胰岛细胞自身免疫抗体诊断儿童1型糖尿病的价值

为探讨儿童初发 1型糖尿病 (T1DM)的诊断指标 ,对 33例 T1DM患儿 (观察组 )分别测定其空腹血糖(FPG)、糖化血红蛋白 (Hb A1 c)、C-肽 (C- P)、胰岛素 (INS)、胰岛细胞抗体 (ICA)及谷氨酸脱羧酶抗体 (GAD) ,并与 33例年龄、性别配对的健康儿童 (对照组 )作比较。结果显示 ,观察组除 FPG、Hb A1 c显著升高外 ,C- P、INS、C-P/ FPG、INS/ FPG均显著低于对照组 ,以 C- P/ FPG最明显。提示空腹 C-肽、INS、C- P/ FPG、INS/ FPG测定对诊断儿童初发 T1DM有重要价值 ;胰岛细胞自身免疫抗体测定对诊断

成人隐匿性自身免疫性糖尿病患者胰岛β细胞功能的6年前瞻性研究

目的 探讨谷氨酸脱羧酶抗体 (GAD Ab)阳性的成人隐匿性自身免疫性糖尿病(LADA)患者胰岛 β细胞功能变化的特点及其影响因素。 方法 GAD Ab阳性的LADA患者 4 5例(LADA 1组 16例 ,LADA2组 2 9例 ) ,年龄 2 8～ 6 8岁 ;GAD Ab阴性的 2型糖尿病 (T2DM )患者 4 5例(T2DM 1组 16例 ,T2DM 2组 2 9例 ) ,年龄 2 6～ 6 8岁。每半年随访一次 ,LADA 1组和T2DM 1组随访至第 6年 ,LADA 2组和T2DM 2组随访至第 1 5年。测定空腹C肽 (FC P)和 10 0g馒头餐后 2hC肽 (2hC P)及糖代谢控制指标。采用放射配体法测定GAD Ab ,放免法测定C P。 结果 LADA1组的FC P较入组时下降 5 0 %以上 ,随访第 1 5年时为 2 5 % ,随访第 2 5年平均水平呈显著性下降[(396± 189) pmol/L对 (5 73± 2 89) pmol/L ,P <0 0 5 ]直至第 6年 ,而T2DM 1组的FC P在随访期间则无显著变化 (P >0 0 5 ) ;LADA患者平均每年FC P下降 15 8% (4 0 %～ 91 0 % ) ,而T2DM平均为 5 2 % (- 3 5 %～ 35 5 % ,P =0 0 0 0 )。LADA患者的FC P与GAD Ab滴度呈负相关 (r =-0 4 83,P =0 0 0 0 ) ;FC P平均每年下降百分数的相关因素为GAD Ab滴度、体质指数 (BMI)和发病年龄 (r分别为 0 4 0 8、- 0 30 1和 - 0 5 2 3,P <0 0 5 )。 结论 LADA患者胰岛 ?

血清胰岛自身抗体在肝源性糖尿病诊断中的价值

目的探讨血清胰岛自身抗体一谷氨酸脱羧酶抗体(GADA)和胰岛细胞抗体(ICA)在肝源性糖尿病诊断中的价值。方法采用酶联免疫吸附实验测定217例慢性乙型肝炎(CH)、肝硬化(LC)患者血清GADA和ICA,观察GADA、ICA在CH、LC阶段的阳性率及其与糖尿病的关系。结果CH、LC合并糖尿病的患者72%(56/77)循环中存在一种胰岛自身抗体,而血糖正常的CH、LC患者胰岛自身抗体的阳性率为30%(42/140),两组比较差异有显著性(χ2=36.620,P=0.000)。CH合并糖尿病患者胰岛自身抗体阳性率52%(13/25)明显高于2型糖尿病(NIDDM)合并肝损害的患者8%(2/25)(P<0.05)。C肽水平下降的CH、LC患者中胰岛自身抗体阳性率70%(24/34)亦明显高与C肽水平正常的患者40%(74/183)(P<0.05)。结论GADA、ICA在肝源性糖尿病的诊断中有重要参考价值,可作为肝源性糖尿病和2型糖尿病的实验室鉴别诊断指标。

GADA、ICA和IAA联合检测对1型糖尿病的诊断价值

目的通过观察1型糖尿病患者血清谷氨酸脱羧酶抗体(GADA)、胰岛细胞抗体(ICA)、胰岛素自身抗体(IAA)的测定结果及其空腹C肽(FCP)和餐后2小时C肽(CP2h)的测定结果,探讨GADA、ICA和IAA联合检测对1型糖尿病的诊断价值。方法采用酶联免疫吸附法(ELISA)检测GADA、ICA和IAA;放射免疫法测定空腹C肽和餐后2小时C肽。结果1型糖尿病患者的GADA、ICA和IAA分别为62.2%、41.5%和37.8%,显著高于2型糖尿病组和正常对照组(P<0.01),其中GADA阳性率显著高于ICA和IAA(P<0.01)。抗体阳性患者的空腹和餐后C肽水平明显低于抗体阴性患者(P<0.01)。青少年组患者ICA阳性率高于GADA和IAA(P<0.01),并且联合检测GADA/ICA和IAA三种抗体检测的阳性率明显高于单一抗体检测的阳性率。成年组及老年组患者GADA阳性率高于ICA和IAA(P<0.01)。3种自身抗体联合检测的敏感性、特异性、阳性预报率、阴性预报率和诊断符合率分别为87.8%、85.7%、93.5%、75.0%和87.2%。结论自身抗体阳性患者可能存在明显的胰岛功能损伤;GADA、ICA和IAA联合检测可以提高诊断敏感性和诊断符合率,并且对1型糖尿病与2型糖尿病的鉴别有重要意义。青少年期患者GADA和ICA组合或GADA、ICA和ICC的联合检测有更大的意义。

成人隐匿性自身免疫性糖尿病的临床特点和诊断要点

目的 探讨 LADA的临床及诊断要点。方法 观察 LADA、成人 1型 DM、重症 2型 DM的临床、血糖、C肽水平、GADAb、ICA等。结果 LADA组自发性酮症 10例 ,GADAb阳性率 10 0 % ,高于 ICA。结论 LADA的诊断依据主要是 : 成人以 2型 DM起病方式发病和治疗 ,β细胞功能逐渐衰退 ,最终需胰岛素治疗 ; GADAb、ICA阳性。