摘要
目的探讨谷氨酸脱羧酶抗体(GAD-Ab)在初诊成人2型糖尿病(T2DM)患者中的阳性率以及成人隐匿性自身免疫糖尿病(LADA)的临床特点。方法用放射配体法检测274例临床初诊为T2DM的患者GAD-Ab,分析GAD-Ab的阳性率及其在各个年龄段的分布特点和临床特征。结果①GAD-Ab在初诊T2DM患者的阳性率为6.9%(19/274);②GAD-Ab阳性率在T2DM患者中30～40岁为11.5%,40～50岁为9.1%,50～60岁为4.4%,60～70岁为2.6%;③LADA组与T2DM组在年龄、性别、HbA1c、空腹C肽、GAD-Ab滴度差异有统计学意义(P<0.05),其血脂代谢、体质量指数(BMI)、DM家族史方面相比差异无统计学意义(P>0.05)。结论①GAD-Ab检测可以提高诊断LADA的敏感性;②GAD-Ab的阳性率和滴度水平与糖尿病患者的临床特征有关系。
Objective In clinical practice, Type 1 and Type 2 diabetic patients are sometimes difficult to distinguish. Latent autoimmune diabetes of the adult （LADA） is a subgroup of diabetes, somewhere on the borderland between Type 1 and Type 2 diabetes. It has been reported that some patients with Type 2 diabetes mellitus （T2DM） have LADA and may show different clinical characteristics than those with T2DM. Glutamic acid decarboxylase autoantibodies （GADA） are the best immune marker to identify LADA patients. We aimed to determine the ratio and clinical fea- tures of LADA in patients with diagnosed initially as T2DM and to compare the clinical characteristics between T2DM and LADA with different titers of GADA. Methods 274 patients with an initial diagnosis of T2DM from the Shanxi Province of China were screened for GADA using a radioligand assay. The distribution and frequency of GADA levels were described. Two hundred and seventy-four patients were divided into the T2DM group （ n = 255） and the LADA group （n = 19） to ctmapare the age of onset, ketotic history, body mass index, waist-to-hip ratio, HbAlc, C-peptide, hypertension and dyslipidemia. Furthermore, LADA patients with different GADA titers were subdivided to analyze the same indexes as the above. Results The prevalence of LADA （defined as GADA^0.05, namely GADA positive） was 6.9% in the 274 initially diagnosed type 2 diabetic patients. Compared with T2DM, LADA patients were younger at their ages of onset, had lower C-peptide and body mass index, and also had less cases with hypertension and with dyslipidemia. However, only patients with high titer of GADA（GADA≥0.5） had poorer beta cell functions and less diabetic complications compared to T2DM and low GADA titer （0.05≤GADA〈 0.5）of LADA patients. Patients with low GADA titer were similar to T2DM patients, except that they were prone to develop ketosis more frequently. Conclusion This study indicated that the important portion of the patients who were initially diagnosed as T
出处
《山西医药杂志》
CAS
2007年第11期970-972,共3页
Shanxi Medical Journal
关键词
糖尿病
2型
谷氨酸脱羧酶
抗体
成人隐匿性自身免疫糖尿病
Diabetes mellitus,type 2
Glutamate decarboxylase
Antibodies
Latent autoimmune diabetes in adults
