SOX13抗体对成人隐匿性自身免疫糖尿病的诊断意义  

Diagnostic role of SOX13 antibody in latent autoimmune diabetes of adults

作　　者：李莉蓉[1] 周智广[1] 黄干[1] 杨琳[1] 李霞[1] 陈小燕[1] 何凌[1] 

机构地区：[1]中南大学湘雅二医院代谢内分泌研究所,长沙410011

出　　处：《中华医学杂志》2005年第4期235-239,共5页National Medical Journal of China

基　　金：国家自然科学基金资助项目(39370343);卫生部优秀青年科技人才专项基金资助项目(Q9420);湖南省卫生厅重点基金资助项目(2001Z04);教育部"跨世纪优秀人才培养计划"基金资助项目(200248);湖南省科技厅重点基金资助项目(03SSY1009)

摘　　要：目的探讨SOX13抗体(SOX13Ab)对成人隐匿性自身免疫糖尿病(LADA)的诊断价值。方法328例隐匿起病糖尿病患者根据谷氨酸脱羧酶抗体(GADAb)和羧基肽酶H抗体(CPHAb)阳性与否分为自身免疫(GADAb和/或CPHAb阳性,130例)和非自身免疫糖尿病(GADAb和CPHAb均阴性,198例)两个亚组,分析SOX13Ab在隐匿起病组及不同亚组中的分布规律。以筛查出的SOX13Ab单一阳性患者为病例组,以GADAb、CPHAb单一阳性和抗体阴性患者为对照组,比较4组临床特征,分析SOX13Ab对隐匿起病糖尿病患者胰岛β细胞功能的影响。结果①隐匿起病组、自身免疫与非自身免疫两亚组中SOX13Ab阳性率均显著高于正常对照组(104%vs.25%,131%vs.25%,86%vs.25%;均P<005);34例SOX13Ab阳性患者中,CPHAb(+)/SOX13Ab(+)双阳性者13例(40%),GADAb(+)/SOX13Ab(+)双阳性者2例(06%),两者差异有统计学意义(P=0007);②SOX13Ab分布峰值处于病程16至20年;③SOX13Ab阳性患者临床特征(包括血糖代谢异常程度、代谢综合佂患病率等)与抗体阴性患者间差异无统计学意义(P>005);④SOX13Ab单一阳性与抗体阴性患者间C肽差异无统计学意义(P>005)。结论①SOX13Ab检测可以提高诊断LADA的敏感性;②SOX13Ab阳性患者具有病程长、临床表现多样等特点。Objective To explore the diagnostic role of SOX13 antibody in latent autoimmune diabetes of adults(LADA). Methods Sera of 328 patients with slow-onset diabetes and 120 sex and age-matched healthy controls underwent radiochemical test to detect the positive rates of SOX13-Ab, glutamic acid decarboxylace antibody (GAD-Ab) and carboxypeptidase H antibody (CPH-Ab). According to the GAD-Ab and CPH-Ab status the patients were divided into autoimmune(GAD-Ab and/or CPH-Ab positive, n=130)and non-autoimmune(GAD-Ab and CPH-Ab negative, n=198) diabetic subgroups . Then according to SOX13-Ab, GAD-Ab and CPH-Ab status, the diabetic patients were divided into 4 groups: SOX13-Ab positive, GAD-Ab positive, CPH-Ab positive, and antibody-negative group to compare their clinical characteristics. The effect of SOX13-Ab on islet β-cell function was evaluated by comparison of C-peptide among the four subgroups. Results The positive rates of SOX13-Ab in the slow-onset diabetic patients (10.4%), autoimmune subgroup patients (13.1%), and non-autoimmune subgroup patients (8.6%) were all higher than that in the healthy controls (2.5%, all P<0.05). Thirteen patients were positive for both SOX13-Ab and CPH-Ab(13/328, 4.0%), but only 2 were positive for both SOX13-Ab and GAD-Ab (2/328,0.6%). The highest prevalence of SOX13-Ab was observed in the patients with the duration of disease ranging from 16 to 20 years. There were no differences in the clinical parameters between the SOX13-Ab positive and antibody-negative diabetic patients. Conclusion SOX13-Ab testing helps improve the sensitivity of screening for LADA. SOX13-Ab positive patients tend to have a longer course of disease and varied clinical manifestations.

关 键 词：阳性 患者 抗体 GAD-AB 阴性 成人隐匿性自身免疫糖尿病 LADA 诊断 代谢 分布 

分 类 号：R587.1[医药卫生—内分泌] R512[医药卫生—内科学]