摘要
目的:检测胰岛素自身抗体(IAA)、胰岛细胞抗体(ICA)、谷氨酸脱羧酶抗体(GADA)和血清C肽,筛选出成年隐匿型自身免疫性糖尿病(LADA)对其进行早诊断、早治疗。方法:采用ELISA法检测188例初诊糖尿病患者血清IAA、ICA和GADA,化学发光法检测空腹和餐后C肽。结果:阳性组50例患者中,GADA阳性率(16.0%)高于ICA阳性率(12.2%)和IAA阳性率(7.4%)。双抗体阳性率为6.9%,三抗体阳性率为1.1%。抗体阳性患者的空腹和餐后C肽明显低于抗体阴性患者,双抗体和三抗体阳性患者的空腹和餐后C肽低于单抗体阳性患者。结论:自身抗体阳性患者的胰岛功能明显低于阴性患者。双抗体或三抗体的阳性患者,其胰岛功能丧失的更多。通过三抗体联合检测在初诊糖尿病患者中筛选LADA,对其早诊断早治疗具重要意义。
Objective To identify the latent autoimmune diabetes in adults (LADA) among the patients with diabetes mellitus for the early diagnosis and treatment. Glutamic acid decarboxylase antibodies (GADA), islet cell antibodies (ICA), insulin autoantibodies (IAA) and the serum C-peptide in 188 patients with recently diagnosed diabetes were measured. Methods GADA, ICA and IAA were analyzed by the enzyme-linked immunosorbent assay(ELISA) and the serum fast and postprandial C-peptide levels were detected by the automated chemiluminescent immunoassay. Results Among 50 antibody-positive patients, the positive rate of GADA was higher than that of ICA and IAA (16.0%, 12.2% and 7.4%, respectively). The positive rate of two antibodies was 6.9% and that of three antibodies was 1.1%. The antibody-positive patients had lower level of fast and postprandial C-peptide than the matched antibody-negative patients (P<0.01). The patients with two or more antibodies positive expression had lower level of fast and postprandial C-peptide than the patients with single antibody positive expression(P<0.05). Conclusions The residual beta-cell function is lower in the antibody-positive patients than that in the antibody-negative patients and more significantly decrease in the patients with two or more antibodies positive expression. The combined measurement of GADA, ICA and IAA for identifying LADA among the diabetes mellitus patients has an important significance in the early diagnosis and treatment.
出处
《诊断学理论与实践》
2005年第1期56-58,共3页
Journal of Diagnostics Concepts & Practice
关键词
患者
C肽
餐后
GADA
隐匿型
自身免疫性糖尿病
空腹
结论
意义
成年
Latent autoimmune diabetes in adults
Glutamic acid decarboxylase antibodies
Islet cell antibodies
Insulin autoantibodies.
