谷氨酸脱羧酶抗体对1型糖尿病的诊断意义  

CLINICAL SIGNIFICANCE OF AUTOANTIBODIES TO GLUTAMIC ACID DECARBOXYLASE IN THE DIAGNOSIS OF TYPE 1 DIABETES MELLITUS

作　　者：修玲玲[1] 余斌杰[1] 胡少眉[1] 许善真 程桦[1] 曾龙驿[1] 

机构地区：[1]中山医科大学内分泌研究室

出　　处：《中山医科大学学报》1998年第4期285-287,共3页Academic Journal of Sun Yat-sen University of Medical Sciences

基　　金：国家教委基金

摘　　要：目的：探讨谷氨酸脱羧酶（ＧＡＤ）抗体与１型糖尿病患者发病年龄、病程及临床特征等的关系。方法：用放射免疫沉淀法测定９２例１型糖尿病和５３例２型糖尿病患者血中ＧＡＤ抗体。结果：１型糖尿病组总的ＧＡＤ抗体阳性率为３９１％，其中儿童１型糖尿病组、成人１型糖尿病组和成人晚发１型糖尿病组的阳性率分别为４６７％、３６８％和４００％，组间无差异；而病程≤１ａ的阳性率５８８％，明显高于病程＞１ａ组的２７４％。患者的ＧＡＤ抗体与空腹Ｃ肽水平、酮症发病史、胰岛素使用量等无明显关系。伴有ＡＩＴＤ患者的ＧＡＤ抗体水平比不伴ＡＩＴＤ患者的ＧＡＤ抗体效价明显增高。结论：ＧＡＤ抗体不仅对１型糖尿病早期诊断而且对成人晚发型１型糖尿病都有临床诊断的价值。Objective: Study the relationship between the frequencies of glutamic acid decarboxylase (GAD) antibodies and age of onset, duration and clinical feature of patients with type 1 diabetes mellitus. Methods: According to WHO criteria of diabetes mellitus, the test sera were taken from 92 patients with type 1,53 with type 2 and 46 normal subjects. GAD antibodies was measured by a sensitive RIA system. Results: The frequencies of GAD antibody positivity among type 1 patients were 39 1% and 58 8% in the shortduration diabetes (≤1 a) and 27 4% in the long duration type 1(>1 a). The incidence of positive GAD antibody among groups of children, adult and adult latent type 1 were 46 7%、36 8% and 40 0% respectively. Compared with negative anti GAD group, positive anti GAD group had no significantly different fasting C peptide levels, daily insulin requirement and ketoacidosis. High levels of GAD antibodies were present in type 1 patients with AITD. Conclusion: The present study confirmed the clinical significance of GAD antibody not only for the early diagnosis of type 1, but also for adult latent type 1.

关 键 词：谷氨酸脱羧酶 糖尿病 IDDM 诊断 抗体 

分 类 号：R587.104[医药卫生—内分泌]