Ⅱ型糖尿病患者GAD-Ab和ICA联合检测及价值  

A Preliminary Study on Significance of Combined Determination of GAD Ab and ICA in Type Ⅱ Diabetes Mellitus

作　　者：叶秀兰[1] 黄山[2] 于瑞萍[3] 周荣霞[4] 莫晓虹[3] 王亚林[3] 董健[3] 邓小林[2] 

机构地区：[1]贵阳医学院附院内分泌科,97级研究生贵阳550004 [2]贵州省临床检验中心 [3]贵州省人民医院内分泌科 [4]贵州省人民医院放免室

出　　处：《贵阳医学院学报》2000年第3期235-237,240,共4页Journal of Guiyang Medical College

摘　　要：对 91例Ⅱ型糖尿病患者及 2 8例正常人的血清 ,用ELLSA法测定谷氨酸脱羧酶抗体(GAD Ab)及胰岛细胞抗体 (ICA)。结果 :Ⅱ型糖尿病人中抗体阳性率为 30 76% ,GAD Ab阳性为17 50 % ,ICA阳性为 15 38% ,双抗体阳性为 2 19% ,对照组GAD Ab和ICA均为阴性 ;抗体阳性各组体重指数 (BMI)较阴性组明显降低 ,且有显著性差异 ;小于 4 0岁患者抗体阳性率最高 ( 60 % ) ;血清C肽水平从低至高依次为双抗体阳性组、GAD Ab阳性组、ICA阳性组、抗体阴性组。提示GAD Ab、ICA联合检测可提高诊断成人迟发性自身免疫性糖尿病 (LADA)敏感性 ;Ⅱ型糖尿病中小于 4 0岁起病及低BMI可作为诊断LADA的一个重要线索 ;To evaluate the significance of glutamic acid decarboxylase antibody(GAD Ab) and islet cell antibody(ICA)determination in type Ⅱ diabetes mellitus . GAD Ab and ICA of 91 patients with type Ⅱ diabetes mellitus were measured with ELISA and serum C-peptide was measured with radioimmunoassay. The autoantibody positive rate was highter than that of GAD Ab (30.76% versus 17.50% P<0.01) and that of ICA (30.76% versus 15.38% P<0.01) in type Ⅱ diabetes mellitus. Body mass index(BMI) was lower in autoantibody positive groups than autoantibody negative group. The autoantibody positive rate was higher in ages<40 group than those in other ages groups. The serum C-peptide leve was double antibody positive group<GAD Ab positive group<ICA positive group<autoantibody negative group. The combined determination of GAD Ab and ICA may enhance the sensitivity of diagnosis of latent autoimmune diabetes mellitus in adults (LADA). It is an important line in diagnosis LADA that BMI is low and ages of onset of type Ⅱ diabetes mellitus is lower than 40 years old. The distroyed level of islet cell is related with the kinds and number of autoantibody.

关 键 词：血清诊断 Ⅱ型糖尿病 ICA GAD-AB ELISA 

分 类 号：R587.104[医药卫生—内分泌] R446.112[医药卫生—内科学]