摘要
目的探讨LADA的诊断指标。方法对168例2型糖尿病患者及100例健康个体进行身高、体重、血糖(空腹及餐后)、C肽(空腹及餐后),以及GADA、ICA、IAA、IA-2等检测。2型糖尿病中抗体阳性者为LADA组,抗体阴性者仍为2型糖尿病。结果GADA、ICA、IAA及IA-2在2型糖尿病组分别为21.18%、14.29%、1.19%及0.60%(GDAA vs ICA/IA-2:21.43%vs14.29%/1.19%,χ2=2.68/33.29,P=0.09/0.00;ICA vs IA-2:14.29%vs 1.19%,χ2=21.09,P=0.00)。发病年龄≤40岁、发病时明显三多一少症状、酮症、无慢性并发症、无高血压、BM I<18.5 kg/m2、FBG≥18.5 mmol/L、FC-P<0.30 nmol/L作为LADA诊断指标,其特异性或阴性预测值较高(90.00%以上)。结论GADA是糖尿病最有价值免疫学指标。发病年龄≤40岁、发病时有症状、酮症、无慢性并发症、无高血压、BM I<18.5 kg/m2、FBG≥18.5 mmol/L、FC-P<0.30 nmol/L可作为LADA临床诊断参考指标。
Objective To evaluate the clinical diagnostic criteria of latent autoimmune diabetes of adults （LADA）. Methods A total of 268 subjects consisted of 168 patients with type 2 diabetes （T2DM） and of 100 normal controls were involved in the study. The body mass index （BMI） was calculated by formula （kg/m^2） and the levels of fasting blood glucose （FBG） , postprandial blood glucose （PBG） , fasting C-peptide （ FC-P）, postprandial C-peptide （ PC-P）, GAD antibody （ GADA）, ICA, IAA and IA-2 antibody were detected. The patients with positive antibody in T2DM group were considered as LADA and the others in T2DM group still as T2DM. Results The GADA, ICA, IA-2 antibody and IAA antibody were detected in 21.18%, 14. 29%, 1.19% and 0. 60% of patients with T2DM, respectively. The indexes such as the age of onset ≤ 40 years old, overt symptom, ketosis, without chronic complication and hypertension, BMI 〈 18. 50 kg/ m^2, FBG≥ 18. 5 mmol/L and FC-P 〈0. 30 nmol/L, have higher specificity and positive predictive valve as the clinical diagnostic criteria of LADA （ 〉90. 00% ）. Conclusion The GADA is the most specific antibody in the diagnosis of patients with autoimmune diabetes. The indexes such as the age of onset ≤40 years, overt symptom, ketosis, without chronic complication and hypertension, BMI 〈 18. 50 kg/m^2, FBG ≥18. 5 mmol/L and FC-P 〈 0. 30 nmol/L may be considered as the clinical diagnostic criteria of LADA.
出处
《中国医师杂志》
CAS
2006年第5期610-613,共4页
Journal of Chinese Physician
基金
广东省卫生厅项目(A2000629)
广东省深圳市卫生局项目(200004002)
科技基金资助项目
