血清谷氨酸脱羧酶抗体滴度与初诊成人2型糖尿病患者第一时相胰岛素分泌的关系  

Relationship between serum glutamic acid decarboxylase antibody titer and the first-phase insulin release in newly-diagnosed type 2 diabetic patients

作　　者：马晓静[1] 包玉倩[1] 周健[1] 潘晓平[1] 陆蔚[1] 胡承[1] 项坤三[1] 贾伟平[1] 

机构地区：[1]上海市糖尿病临床医学中心,上海市糖尿病研究所,上海交通大学附属第六人民医院内分泌代谢科,200233

出　　处：《中华内分泌代谢杂志》2010年第2期122-124,共3页Chinese Journal of Endocrinology and Metabolism

基　　金：基金项目：上海市糖尿病重点实验室项目（08DZ2230200）;上海市市级医院新兴前沿技术联合攻关项目（SHDC12006101）和上海市科学技术发展基金[01ZD002（1）]

摘　　要：探讨不同血清谷氨酸脱羧酶抗体（GAD—Ab）滴度与初诊成人2型糖尿病患者第一时相胰岛素分泌（1PH）的关系。对1053例初诊2型糖尿病患者，按GAD—Ab滴度分为3组，其中抗体阳性组（GAD—Ab≥1U／m1）71例、抗体阴性1组（0〈GAD—Ab〈1U／m1）171例及抗体阴性2组（GAD—Ab=0）811例，用精氨酸刺激试验评估1PH。结果见到抗体阴性2、抗体阴性1、抗体阳性3组的1PH呈逐渐下降趋势（P〈0．01），其胰岛素分泌功能缺陷检出率分别为74．85％、87．13％和100％。多元逐步回归分析显示，病程、GAD—Ab滴度、HbA1C及体重指数为1PH的独立影响因素。提示GAD—Ab滴度对临床初诊2型糖尿病患者1PH缺陷有重要影响，检测GAD—Ab不仅为临床分型提供重要依据，而且有助于判断胰岛B细胞功能。To investigate the relationship between serum glutamic acid decarboxylase antibody （GAD- Ab）titer and the first-phase insulin release （1PH）in newly-diagnosed type 2 diabetic patients. 1053 newly- diagnosed type 2 diabetic patients were divided into 3 groups, including 71 individuals with GAD-Ab ≥ 1 U/ml （ positive group）, 171 individuals with GAD-Ab ranging from 0 to 1 U/ml （ negative-1 group）, and 811 individuals with GAD-Ab = 0 （ negative-2 group）. 1PH was evaluated by arginine stimulation test. In the patients of negative-2, negative-l, and positive groups, the respective values of 1PH were subsequently decreased significantly （P〈 0.01） ,and the detection rates of the decreased insulin secretion were 74. 85%, 87. 13%, and 100%, respectively. Stepwise regression analysis indicated that disease duration, GAD-Ab titer, HbA1C, and body mass index were the major independent contributing factors. The titer of GAD-Ab has an important impact on 1PH defect in type 2 diabetic patient. Detection of GAD-Ab not only provides an evidence for clinical type, but would also be helpful in determining the islet β-cell function.

关 键 词：糖尿病 谷氨酸脱羧酶抗体 精氨酸刺激试验 

分 类 号：R587.1[医药卫生—内分泌]