成人迟发性自身免疫性糖尿病在临床诊断为2型糖尿病患者中的检出及临床特点  

Detection and clinical characteristics of adult latent autoimmune diabetes in patients with type 2 diabetes

作　　者：邹健 田丰 孔祥勇 武跃丽 

机构地区：[1]解放军522医院内科,河南洛阳471003 [2]解放军522医院妇产科,河南洛阳471003

出　　处：《总装备部医学学报》2012年第4期197-199,共3页Medical Journal of General Equipment Headquarters

摘　　要：目的探讨谷氨酸脱羧酶抗体(GADA)、胰岛素细胞抗体(ICA)、胰岛素自身抗体(IAA)联合检测在临床诊断为2型糖尿病患者中尽早筛选出成人迟发性自身免疫性糖尿病(LADA)的临床指导意义。方法通过对我院门诊和住院糖尿病患者的随诊和回访,选出临床初步诊断为2型糖尿病304例,抽取其静脉血,采用酶联免疫吸附试验(ELISA)测定血清中GADA、ICA、IAA。结果在304例中,GADA阳性率为15.8%,ICA阳性率为13.2%,IAA阳性率为14.8%;共诊断LADA20例,其中GADA阳性11例(占55%),ICA阳性8例(占40%),IAA阳性15例(占75.0%)。结论 GADA、ICA、IAA与LADA的发病高度相关;这些抗体的出现预示着胰岛β细胞功能受损,有助于从2型糖尿病患者中尽早筛选出LADA者,以利于临床早期应用胰岛素治疗,从而延缓LADA患者胰岛β细胞功能的衰竭。Objective To study the positive rates of autoantibodies to glutamic acid decarboxylase (GADA), islet cell antibodies (ICA), and insulin autoantibodies (IAA) in type 2 diabetes and its clinical implications in early detection of latent autoimmune diabetes of adults (LADA). Methods GADA, ICA and IAA in serum were determined by ELISA in 304 cases of type 2 diabetes in this hospital, with clinical follow-up. Results In the 304 patients, the positive rate of GADA was 15.8%; that of ICA was 13.2%; that of IAA was 14.8%. In all, 20 patients were diagnosed as LADA, the positive rates of GADA was 55.0%, the positive rates of ICA was 40.0%, the positive rates of IAA was 75.0%. Conclusion The increase of GADA, ICA and IAA in serum, indicating the damage of pancreatic β islet cell function in patients with type 2 diabetes, is significantly correlated with the pathogenesis of LADA. For these patients, the early treatment with insulin would retard the deterioration of pancreatic β islet cell function.

关 键 词：成人迟发性自身免疫性糖尿病 2型糖尿病 胰岛Β细胞 自身抗体 

分 类 号：R587.1[医药卫生—内分泌]