2型糖尿病患者胰岛素抗体产生状况分析  

A clinical analysis of insulin antibody in type 2 diabetic patients

作　　者：欧阳晓俊[1] 卞茸文[2] 顾刘宝[2] 巫海娣[2] 莫永珍[2] 娄青林[2] 俞匀[2] 

机构地区：[1]江苏省老年医学研究所江苏省老年医院干部保健科,南京210024 [2]江苏省老年医学研究所糖尿病防治研究中心,南京210024

出　　处：《中华内科杂志》2016年第7期544-546,共3页Chinese Journal of Internal Medicine

基　　金：江苏省科技厅软科学项目（BR2015073）

摘　　要：分析2型糖尿病（T2DM）患者胰岛素抗体（IA）产生影响因素及其与血清胰岛素水平的关系。647例T2DM患者按是否使用胰岛素分组，比较IA阳性和阴性临床指标差异。结果：（1）总体IA阳性率为20．9％。IA阳性患者较阴性患者年龄大，病程较长，谷氨酸脱羧酶抗体（GAD）阳性率较高，胰岛素释放试验各点胰岛素水平均较高（P值均=0．000）。（2）IA阳性患者胰岛素使用率明显高于IA阴性患者（65．9％比41．0％，P=0．000）。（3）在总体和胰岛素治疗组，高空腹胰岛素水平与IA阳性有明显关联性（OR=1．020，P=0．001和OR=1．033，P=0．002）。（4）ROC曲线分析在胰岛素治疗组空腹血清胰岛素水平预测IA阳性的诊断切点为17．87mlU／L（敏感度55．1％，特异度89．0％）。外源胰岛素使用与IA产生相关。空腹胰岛素水平可作为使用胰岛素患者IA阳性的预测指标。This study was conducted to evaluate the relationship between serum insulin levels and the production of insulin antibody （IA） in type 2 diabetes （T2DM）. A total of 647 T2DM were included. Among them, 20. 9% patients were IA positive, who were elder and had a longer duration, lower BMI, a higher positive rate of glutamic acid decarboxylase antibody（GADAb） and higher serum insulin levels during an insulin secretion test. More patients were treated with insulin in IA positive group than in IA negative group （65.9% vs 41.0% , P =0. 000）. Fasting serum insulin level was associated with occurrence of IA in all patients （OR = 1.02, P = 0. 001 ） and insulin treated patients （ OR = 1. 033, P = 0. 002）. The cut-off point of fasting serum insulin level for predicting IA positive was 17.87 mIU/L （ sensitivity 55.1% , specificity 89. 0% ）. Exogenous insulin use is associated with the presence of IA. Fasting serum insulin level can be used as a predictor for the production of IA in insulin-treated patients.

关 键 词：糖尿病 2型 胰岛素抗体 

分 类 号：R587.1[医药卫生—内分泌]