谷氨酸脱羧酶抗体在初诊成人2型糖尿病患者中的阳性率及其分布特点  

Study on the positive frequency and distribution of glutamic acid decarboxylase antibody in phenotypic type 2 diabetic patients

作　　者：李霞[1] 周智广[1] 黄干[1] 彭健[1] 颜湘[1] 杨琳[1] 王建平[1] 邓志明[1] 

机构地区：[1]中南大学湘雅二医院内分泌科,代谢内分泌研究所,中南大学糖尿病中心,长沙410011

出　　处：《中华流行病学杂志》2005年第10期800-803,共4页Chinese Journal of Epidemiology

基　　金：湖南省科技厅重点项目(03SSY1009)面上项目(02SSY3065)湖南省卫生厅重点项目(2001-Z04)基金资助

摘　　要：目的探讨谷氨酸脱羧酶抗体(GAD-Ab)在初诊成人2型糖尿病患者中的阳性率及其分布特点。方法用放射配体法检测2035例临床初诊为2型糖尿病(T2DM)患者的GAD-Ab,分析GAD-Ab的阳性率及其分布与临床特征的关系。结果①成人隐匿性自身免疫糖尿病在以医院为基础、初诊T2DM患者中的患病率为7.1%(145/2035),与在欧美高加索人中进行的大规模研究UKPDS 的结果差异无统计学意义(8.7%vs.9.8%,P=0.391),而高于ADOPT研究(8.0%vs.4.2%,P= 0.000)和日本的Ehime研究结果(7.1%vs.3.8%,P=0.000);②GAD-Ab的阳性率和滴度分布与起病年龄、体重指数和空腹C肽等临床特征有关,起病年龄小、体重指数低和空腹C肽低者具有较高的阳性率和滴度。结论①中国成人初诊T2DM患者的GAD-Ab阳性率与欧美高加索人接近,而高于日本人群;②GAD-Ab的阳性率和滴度与糖尿病患者的临床特征存在关联。Objective To investigate the positive frequency and distribution of glutamic acid decarboxylase antibody（GAD-Ab） in phenotypic type 2 diabetic（T2DM） patients. Methods Sera of 2035 phenotypic T2DM patients were screened for GAD-Ab with radioligand assay. The positive frequency of GAD-Ab and its relation with clinical features were analyzed. Results （ 1 ） The positivity of GAD-Ab in clinic-based,phenotypic T2DM patients was 7.1% （145/2035）,comparable to that of data from Caucasians as shown by UKPDS（8.7% vs. 9.8%,P=0.391） and ADOPT（8.0% vs. 4.2%,P=0.000） but higher than that of Japanese in Ehime study（7.1% vs. 3.8 % , P = 0. 000）. （2） The positive frequency and distribution of GAD-Ab titer were related to clinical features, including age at onset, body mass index （BMI） and fasting C peptide levels. Patients with younger age at onset（0.33 vs. 0.11, P 〈 0.05）, less BMI（0.34 vs. 0.10,P〈0.05）and lower C peptide levels（0.38 vs. 0.11,P〈0.05） would have higher GAD-Ab titers. Conclusion （1）The positivity of GAD-Ab in adult-onset phenotypic T2DM in Chinese was similar to that of Caucasians but higher than that of the Japanese. （2）The distribution of GAD-Ab titers was associated with clinical features, with high GAD-Ab titers for those having younger age at onset, less BMI and lower C peptide levels.

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 

分 类 号：R587.1[医药卫生—内分泌] R181.21[医药卫生—内科学]