摘要
目的探讨联合胰岛素自身抗体(IAA)、谷氨酸脱羧酶抗体(GADA)、抗胰岛素细胞抗体(ICA)检测诊断成人隐匿性自身免疫性糖尿病(LADA)的应用价值。方法选取2017年11月-2018年11月该院收治的420例初诊2型糖尿病患者为研究对象,根据其最终的临床确诊结果分为392例2型糖尿病患者和28例隐匿性自身免疫性糖尿病患者。所有患者均进行胰岛自身抗体及生化指标检测,包括IAA、GADA、ICA和空腹血糖(FBG)、餐后2 h血糖(2 hFBG)、空腹C肽、餐后2 hC肽与糖化血红蛋白(HbA1c)。结果420例初诊2型糖尿病患者,确诊为LADA患者28例,检出率为6.67%。LADA患者的IAA、GADA、ICA阳性率及IAA+GADA+ICA阳性率,均显著高于2型糖尿病患者,比较差异有统计学意义(P<0.05)。与2型糖尿病患者相比,LADA患者的FBG、2 hFBG和HbAlc值,均明显更高,比较差异有统计学意义(P<0.05);且其空腹C肽和餐后2 hC肽,明显更低,比较差异有统计学意义(P<0.05)。结论联合3种胰岛自身抗体检测与生化指标水平检测能够显著提高LADA的诊断准确率,为临床治疗提供可靠指标,可将该诊断方式进行临床推广应用。
Objective To explore the application value of IAA,GADA and ICA in the diagnosis of latent autoimmune diabetes mellitus(LADA).Methods A total of 420 newly diagnosed type 2 diabetic patients admitted to the hospital from November 2017 to November 2018 were selected as the research objects.According to the final clinical diagnosis results,they were divided into 392 type 2 diabetic patients and 28 patients with latent autoimmune diabetes.All patients were tested for islet autoantibodies and biochemical indicators,including IAA,GADA,ICA and fasting blood glucose(FBG),postprandial blood glucose(2 hFBG),fasting C-peptide,postprandial C-peptide and HbA1c.Results Among 420 newly diagnosed patients with type 2 diabetes mellitus,28 were diagnosed as LADA,the detection rate was 6.67%.The positive rates of IAA,GADA,ICA and IAA+GADA+ICA in LADA were significantly higher than those in type 2 diabetes(P<0.05).Compared with type 2 diabetic patients,the FBG,2 hFBG and HbAlc values of LADA patients were significantly higher,the difference was statistically significant(P<0.05),and the fasting C-peptide and postprandial 2 h C-peptide were significantly lower,the difference was statistically significant(P<0.05).Conclusion The combination of three kinds of islet autoantibodies and biochemical indicators can significantly improve the diagnosis accuracy of LADA,provide reliable indicators for clinical treatment,and promote the clinical application of this diagnosis.
作者
陈明真
CHEN Ming-zhen(Department of laboratory,the Second Affiliated Hospital of Fujian Medical University,Quanzhou,Fujian Province,362000 China)
出处
《糖尿病新世界》
2020年第15期23-25,共3页
Diabetes New World Magazine
