自身抗体及生化指标在成人隐匿性自身免疫性糖尿病诊断中的检验效果分析  

Analysis of the Effect of Autoantibodies and Biochemical Indicators in the Diagnosis of Latent Autoimmune Diabetes in Adults

作　　者：王佳佳 林洁[1] 肖小芬[1] WANG Jiajia;LIN Jie;XIAO Xiaofen(Clinical Laboratory Center,Zhongshan Hospital Affiliated to Xiamen University,Xiamen,Fujian Province,361004 China)

机构地区：[1]厦门大学附属中山医院临床检验中心,福建厦门361004

出　　处：《糖尿病新世界》2021年第18期77-80,共4页Diabetes New World Magazine

摘　　要：目的观察分析胰岛自身抗体及生化指标检测应用于成人隐匿性自身免疫性糖尿病(LADA)诊断时的效果。方法将该院内分泌科2019年1月—2020年12月收治的已经确诊为LADA疾病的患者70例纳入观察组,将同期在该院接受治疗的已经确诊为2型糖尿病的患者70例纳入对照组。组织两组患者接受胰岛自身抗体及生化指标检测。基于胰岛自身抗体检测结果(胰岛素自身抗体、谷氨酸脱羧酶抗体、抗胰岛素细胞抗体),比对两组LADA阳性检出情况;比对两组患者的3项血糖检测指标(空腹血糖、餐后2 h血糖、糖化血红蛋白)、空腹C肽和餐后2小时C肽两项指标。结果①观察组患者IAA、GADA、ICA,3项指标的阳性检出率分别为34.29%、47.14%、42.86%,与对照组相比差异有统计学意义(χ^(2)=25.760、43.178、38.845,P<0.001);②观察组患者的空腹血糖和餐后2 h血糖相比,差异无统计学意义(t=0.056,P=0.956);对照组患者的空腹血糖水平显著低于餐后2 h血糖,差异有统计学意义(t=5.403,P<0.05);③观察组患者的空腹血糖、餐后2 h血糖、糖化血红蛋白水平均高于对照组,差异有统计学意义(t=6.419、2.034、7.080,P<0.05);④观察组患者的空腹C肽及餐后2 hC肽水平均明显低于对照组,差异有统计学意义(t=28.725、10.826,P<0.05)。结论综合胰岛自身抗体及生化指标检测结果,可清晰区分LADA和普通2型糖尿病。Objective To observe and analyze the effect of islet autoantibodies and biochemical indicators in the diagnosis of latent autoimmune diabetes in adults(LADA).Methods 70 patients who were diagnosed with LADA disease admitted to the Department of Endocrinology in the hospital from January 2019 to December 2020 were included in the observation group,and 70 patients with type 2 diabetes who were treated in our hospital during the same period were included in the control group.Organize two groups of patients to receive islet autoantibody and biochemical index testing.Based on the test results of islet autoantibody(insulin autoantibody,glutamate decarboxylase antibody,anti-insulin cell antibody),compare the two groups of LADA positive detection;compare the three blood glucose detection indicators of the two groups of patients(fasting blood glucose,meal after 2 h blood glucose,glycosylated hemoglobin),fasting C peptide and 2 hours postprandial C peptide indicators.Results 1.The positive rates of IAA,GADA and ICA in observation group were 34.29%,47.14%and 42.86%,respectively,and the differences were statistically significant compared with control group(χ^(2)=25.760,43.178,38.845,P<0.001).2.There was no statistically significant difference in fasting blood glucose between observation group and 2 h postprandial blood glucose(t=0.056,P=0.956);Fasting blood glucose level in control group was significantly lower than 2 h postprandial blood glucose,the difference was statistically significant(t=5.403,P<0.05).3.The levels of fasting blood glucose,2 h postprandial blood glucose and hba1c in observation group were higher than those in control group,the differences were statistically significant(t=6.419,2.034,7.080,P<0.05).4.The levels of fasting C-peptide and postprandial 2 hC peptide in observation group were significantly lower than those in control group,the differences were statistically significant(t=28.725,10.826,P<0.05).Conclusion Comprehensive islet autoantibody and biochemical index test results can clearly distinguish

关 键 词：胰岛自身抗体检测 生化指标检测 成人隐匿性自身免疫性糖尿病 

分 类 号：R59[医药卫生—内科学]