佛山地区初诊2型糖尿病患者中LADA的患病率调查  

Study on prevalence of latent autoimmune diabetes in adults from phenotypic type 2 diabetic patients of Foshan

作　　者：黄秉文[1] 方咏红[1] 卢颖瑜[1] 谢文卿[1] 

机构地区：[1]佛山市第二人民医院内分泌科,广东佛山528000

出　　处：《海南医学》2015年第5期641-644,共4页Hainan Medical Journal

基　　金：佛山市医疗卫生科研基金(编号:2013079)

摘　　要：目的调查佛山地区临床初诊2型糖尿病患者中成人隐匿性自身免疫性糖尿病(LADA)的患病率及其与2型糖尿病临床特点的差别。方法对526例临床初诊为2型糖尿病患者用化学发光法测定谷氨酸脱羧酶抗体(GAD-Ab)、酪氨酸磷酸酶蛋白抗体(ICA-Ab)及胰岛素自身抗体(IAA-Ab),计算LADA的患病率并分析其临床特点。结果 (1)临床初诊2型糖尿病患者中LADA患者检出率为5.9%(31/526),其中GAD-Ab、ICA-Ab及IAA-Ab的阳性检出率为5.2%、2.3%及0.9%。(2)病程1年内的初诊2型糖尿病患者其LADA检出率为11.3%,高于病程1年以上患者的4.6%(P<0.05)。(3)LADA检出率与患者的临床特征有关,无家族发病史、低体重、低C-肽水平及发病年龄小者有较高LADA发生风险。(4)43.6%的LADA患者伴有两种以上代谢异常,其患病率由高到低依次为:血脂异常、高血压、肥胖。在LADA患者中有16.1%的代谢综合征(MS)患病率。结论 (1)临床初诊为2型糖尿病患者中有5.9%为LADA,应及早进行糖尿病抗体检测及临床干预。(2)超过2/5的LADA患者有多种代谢异常,提示LADA患者应进行代谢方面检查以进行早期干预。Objective To investigate the prevalence, clinical features of latent autoimmune diabetes in adults （LADA） from phenotypic type 2 diabetic patients in Foshan. Methods Serum from 526 phenotypic type 2 diabetic patients were screened for glutamic acid decarboxylase autoantibody （GAD-Ab）, anti-islet cell autoantibody （ICA-Ab） and anti-insulin autoantibody （IAA-Ab） through radioligand binding assay. The prevalence of LADA and its relation with clinical features were analyzed. Results （1） The prevalence of LADA in phenotypic type 2 diabetic patients was 5.9%（31/526）. The positive frequency of GAD-Ab, ICA-Ab and IAA-Ab was 5.2%, 2.3%and 0.9%, respectively. （2） The prevalence of LADA from phenotypic type 2 diabetic patients with a duration of diabetic less than 1 year was significantly higher than that of patients with a duration over 1 year （11.3%vs 4.6%, P〈0.05）. （3） The prevalence of LADA was higher in patients with younger age at onset, lower body mass index and lower level of postprandial C pep-tide and without diabetes family history. （4） 43.6%of LADA patients suffered from at least one kind of metabolic dis-orders besides hyperglycemia, 16.1%of which were with MS. The metabolic disorders of prevalence from high to low were as follows：hypertension, dyslipidemia, overweight/obesity. Conclusion （1） 5.9%of phenotypic type 2 diabetic patients had LADA, which should be given early diagnosis of diabetic type and clinical intervention. （2） Approximate-ly 2/5 patients with MS were found in LADA patients, indicating that overall screening and intervention of metabolic disorder factors is important in LADA patients.

关 键 词：成人隐匿性自身免疫性糖尿病 谷氨酸脱羧酶抗体 酪氨酸磷酸酶蛋白抗体 胰岛素自身抗体 患病率 

分 类 号：R587.1[医药卫生—内分泌]