摘要
目的通过对血清谷氨酸脱羧酶抗体(GAD)、胰岛细胞抗体(ICA)、血糖、糖化血红蛋白(HbA1c)的联合检测,探讨临床诊断为2型糖尿病(T2DM)患者中发现成人隐匿性自身免疫性糖尿病(LADA)的意义和诊断价值。方法测定349例T2DM患者的血清GAD、ICA、C肽、血糖及HbA1c,检测出其中的LADA患者,并与T2DM患者的各项指标进行比较分析。结果 349例T2DM患者中共确诊为LADA患者27例(7.74%)。LADA患者空腹C肽及餐后2hC肽分别为(0.31±0.21)、(0.90±0.22)μg/L,较T2DM患者的空腹C肽(1.23±0.85)μg/L和餐后2hC肽(3.45±2.96)μg/L明显降低,差异有统计学意义(P<0.05)。LADA患者空腹血糖及HbA1c分别为(12.15±25.01)mmol/L、(10.12±2.78)%,较T2DM患者的(9.45±13.07)mmol/L、(8.04±2.95)%明显升高,差异有统计学意义(P<0.05)。结论各项指标联合胰岛β细胞自身抗体检测可提高LADA患者的检出率,有助于LADA的早期诊断。
Objective To perform the combined detection of serum glutamic acid decarboxylase antibody（GA- DA）, islet cell antibody（ICA）, blood glucose, glycosylated hemoglobin（HbAlc）, and to discuss its significance and di- agnostic value to find latent autoimmune diabetes in adults（LADA） patients with type 2 diabetes mellitus（T2DM）. Methods The levels of serum GAD,ICA,proinsulin C-peptide,blood glucose and HbAlc in 349 cases of T2DM were measured for finding out the patints with LADA and compared with various indexes in the patients with T2DM.. Re- suits Among 349 cases of T2DM,27 cases were detected LADA （7.74%）. The levels of fasting plasma C-peptide and 2 h postprandial C-peptide in the patients with LADA were （0.31±_0.21）μg/L and （0. 90±0.22） μg/L,which were lower than （1.23 ±0.85） μg/L and （3.45 ± 2.96）μg/L in the patients with T2DM, showing statistical differ- ence（P 〈 0.05）. The fasting glucose and H bAlc in the patients with LADA were （12. 15 ± 25. 01 ）mmol/L and （10.12±2.78） %and significantly higher than （9.45 ±13.07） mmol/L and （8.04 ±2.95） % in the patients with T2DM with statistical difference between them（P〈0.05）. Conclusion The combined detection of insulin B cell au- toantibody and biochemical indexes could increase the detection rate of LADA, which is beneficial to the early diagno- sis of LADA.
出处
《检验医学与临床》
CAS
2012年第12期1430-1431,共2页
Laboratory Medicine and Clinic
关键词
谷氨酸脱羧酶抗体
胰岛素抗体
糖化血红蛋白
成人隐匿性糖尿病
glutamic acid decarboxylase antibody
insulin antibody
glycosylatedhemoglobin
latent au- toimmune diabetes in adults
