胰岛自身抗体对Ⅰ型糖尿病诊断效率的研究  

Diagnostic efficacy of glutamic acid decarboxylase antibody and islet cell antibody in type Ⅰ diabetes mellitus

作　　者：欧阳玲莉[1] 王建民[2] 朱旭平[2] 彭健[2] 周智广[2] 伍汉文[2] 

机构地区：[1]广西医科大学第一附属医院内分泌科,南宁530021 [2]湖南医科大学第二附属医院内分泌科,长沙410011

出　　处：《中华内科杂志》2000年第10期674-676,共3页Chinese Journal of Internal Medicine

摘　　要：目的　探讨免疫指标谷氨酸脱羧酶抗体 (GAD65 Ab)与胰岛细胞抗体 (ICA)对I型糖尿病的诊断价值。方法　Ⅰ型糖尿病 10 4例 ,正常对照 10 2例 ,用放射配体分析法检测GAD65 Ab ,ELISA法检测ICA ;用受试者运筹特性 (ROC)曲线及曲线下面积比较二者的诊断效率。结果　 ( 1)GAD65 Ab最佳界值 0 30 ,ICA最佳界值 0 45。GAD65 Ab、ICAROC曲线下面积分别为 0 835、0 715 ;与 0 5比较 ,差异均有显著性 (P <0 0 0 0 1) ;且GAD65 Ab、ICA两组间差异有显著性 (P <0 0 1)。 ( 2 )GAD65 Ab阳性检出率与Ⅰ型糖尿病的发病年龄、病程无关 ,ICA阳性检出率与Ⅰ型糖尿病的发病年龄、病程有关(P <0 0 5 )。结论　GAD65 Ab、ICA均有诊断Ⅰ型糖尿病的价值 ,GAD65 Ab的诊断效率优于ICA。GAD65 Ab对成年发病、病程较长 ( >1年 )的Ⅰ型糖尿病诊断效率较ICA高 ;ICA对少年起病、病程 <1年的Ⅰ型糖尿病诊断效率较GAD65 Ab高。Objective To investigate the diagnostic efficacy of glutamic acid decarboxylase antibody (GAD 65-Ab) and islet cell antibody (ICA) in type Ⅰ diabetes mellitus. Methods 104 cases of type Ⅰ diabetes mellitus and 102 normal controls were recruited, GAD 65-Ab was determined with radioligand assay and ICA with ELISA. The diagnostic efficacy of GAD 65-Ab and ICA was analysed by receiver-operating characteristic(ROC) curve with sensitivity, specificity and curve area. Results (1)The optimal cut-off point of GAD 65-Ab was at 030, while that of ICA was at 045. The area under the curve of GAD 65-Ab and ICA were 0835 and 0715 respectively. Compared with 0.5, the area under curve of GAD 65-Ab and ICA was higher (P<0.000 1). The area under curve of GAD 65-Ab was higher than that of ICA(P<0.01). (2)In type Ⅰ diabetes mellitus patients, the positivity of GAD 65-Ab was not correlated to the age of onset and duration of the disease, while the positivity of ICA was correlated to the age of onset and duration. Conclusion Type Ⅰ diabetes mellitus can be diagnosed with GAD 65-Ab and ICA. The diagnostic efficacy of GAD 65-Ab is higher than that of ICA. In patients of type Ⅰ diabetes mellitus with adult-onset and duration more than one year, the diagnostic efficacy of GAD 65-Ab is higher than that of ICA, while in patients of type Ⅰ diabetes mellitus with adolescent-onset and duration less than one year, the diagnostic efficacy of ICA is higher than that of GAD 65-Ab.

关 键 词：Ⅰ型糖尿病 胰岛自身抗体 ROC曲线 诊断 

分 类 号：R587.1[医药卫生—内分泌]