Ⅱ型糖尿病患者血清中GAD-Ab测定的临床意义  

Clinical significance of GAD-Ab in patients with type Ⅱ diabetes

作　　者：叶秀兰[1] 于瑞萍[1] 周荣霞[2] 莫晓虹[1] 王亚林[1] 黄山[3] 邓小林[3] 

机构地区：[1]贵州省人民医院内分泌科,贵阳550002 [2]贵州省人民医院放免室,贵阳550002 [3]贵州省临床检验中心,贵阳550002

出　　处：《贵州医药》2000年第8期469-470,共2页Guizhou Medical Journal

摘　　要：目的通过谷氨酸脱羧酶抗体 (GAD Ab)测定 ,了解成人迟发性自身免疫性糖尿病 (LA DA)在Ⅱ型糖尿病中的发病率 ,以及LADA的一些临床特点。方法对 91例诊断为Ⅱ型糖尿病患者及2 8例正常对照组用ELISA法检测血清中GAD Ab。结果GAD Ab阳性率 17 5 8% ,高于对照组的 0 % ;且GAD Ab阳性患者具有低体重指数 (BMI)≤ 2 1kg m2 ,低C肽分泌 ,酮症史 ,胰岛素用量偏大的临床特点 ;而起病年龄、病程及男女比例与阴性无显著差异。结论LADA在Ⅱ型糖尿病中比例较高 ;Ⅱ型糖尿病中低BMI,低C肽分泌 ,酮症史 ,胰岛素用量偏大是LADA诊断的重要线索 ;GAD Ab检测对早期诊断LADA有实验价值。Objective To investigate the incidence rate of latent autoimmune diabetes of adults(LADA)in patients initially diagnosis as type Ⅱ DM and some clinic features of LADA. Methods GAD Ab were measured by ELISA in 91 patients initially diagnosis type Ⅱ diabetes(DM) and 28 healthy subjects. Results The positive rate of GAD Ab was 17.58% in DM and was 0% in healthy subjects.The cases of GAD Ab positive in type ⅡDM group with body mass index (BMI)≤21kg/m 2,low secretion of C-peptide,ketotic history and a large dose insulin was used in treatment.Age at onset of diabetes,course of disease and sex were not related to GAD Ab positive.Conclusion The patients initially diagnosed as type Ⅱ DM may actually be LADA.The important clues for the diagnosis of LADA may include weight loss,insulin deficiency,ketotic history and a large dose of insulin was used in treating patients.The GAD Ab has a practical value in identifying LADA at early stage of the disease

关 键 词：谷氨酸脱羧酶抗体 Ⅱ型糖尿病 诊断 LADA 

分 类 号：R587.1[医药卫生—内分泌]