1型糖尿病一级亲属胰岛自身抗体筛查与胰岛β细胞功能研究  

Immunological characteristics and pancreatic β-cell function in first-degree relatives of type 1 diabetes mellitus

作　　者：王建平[1] 周智广[2] 黄干[2] 袁颖[2] 周海峰[2] 侯粲[2] 杨亚玲[2] 

机构地区：[1]南华大学附属第二医院内分泌科,421001衡阳 [2]中南大学湘雅二医院代谢内分泌研究所,长沙

出　　处：《中华内分泌代谢杂志》2011年第6期485-488,共4页Chinese Journal of Endocrinology and Metabolism

基　　金：国家重点基础研究发展计划项目（2006CB503901）

摘　　要：419名1型糖尿病患者一级亲属进行葡萄糖耐量试验，采用放射配体法检测谷氨酸脱羧酶抗体（GADA）、酪氨酸磷酸酶抗体（IA-2A）与胰岛素自身抗体（IAA），检出率分别为7.16％、1.43％与1.26％。其中11名抗体阳性一级亲属（Ab^＋组）、14名抗体阴性一级亲属（Ab-组）与39名对照者分别于5～7 d内进行IVGTT与那格列奈一葡萄糖耐量试验（OGTT）。Ab^＋组第一时相胰岛素分泌[FPIR（4.80±0.24对5.25±0.66）mU／L]、10 min内胰岛素曲线下面积AUC0.10[（6.18±0.30对6.61±0.63）mU·min^-1·L^-1]与胰岛素净增值／血糖净增值比值[△I30／△G30（2.75±0.37对3.61±1.05）mU／mmol]低于对照组（均P〈0.05）。Ab^＋组1 min胰岛素释放低于Ab-组[（3.80±0.30对4.52±0.70）mU／L，P〈0.05]。Ab一组稳态模型评估的胰岛素抵抗指数（HOMA-IR）高于正常对照组（2.92±1.04对1.96±1.22，P〈0.05）。提示本组l型糖尿病一级亲属胰岛自身抗体检出率与欧美白种人接近。胰岛自身抗体阳性一级亲属可能存在一定程度的胰岛β细胞功能减退，抗体阴性一级亲属可能存在一定程度的胰岛素抵抗。Oral glucose tolerance test（OGTY） was performed in 419 first-degree relatives （FDRs） of type 1 diabetes mellitus. GADA, IA-2A, and IAA were determined by radioligand assay, and the positive rates were 7. 16%, 1.43% , and 1.26% , respectively. Intravenous glucose tolerance test（IVG3T） and nateglinide-OGTF were performed in 39 controls, 11 first-degree relatives with positive autoantibody （ Ab^＋group）, 14 ones with negative autoantibody （Ab-group） during 5-7 days. The first-phase insulin release （ FPIR）, area under insulin release daring 0-10 min [ AUC0-10 ] of IVGTF and the value of（ AI30/AG30 ） of nateglinide-OGTF in Ab^＋ group were lower than those of control group [ （4. 80±0. 24 vs 5.25 ±0. 66）mU/L, （6. 18±0. 30 vs 6. 61 ±0. 63 ）mU · min^-1·L^-1, and（2. 75 ±0. 37 vs 3.61 ± 1.05 ） mU/mmol, all P〈 0. 05 ]. The 1 st min insulin release in Ab^＋group was lower than that of Ab-group [ （3.80±0. 30 vs 4. 52±0. 70）mU/L, P〈0. 05 ]. The HOMA-IR was higher in Ab-group than that in control group （ 2. 92± 1.04 vs 1.96± 1.22, P〈0. 05 ）. The results suggest that the positivity rates of autoantibodies in FDRs of type 1 diabetes mellitus are very close to those of Caucasian. There exist insulin secretion defects in FDRs with positive autoantibody while insulin resistance in FDRs with negative autoantibody.

关 键 词：糖尿病 1型 一级亲属 胰岛自身抗体 胰岛Β细胞功能 那格列奈 

分 类 号：R587.1[医药卫生—内分泌]