普通成年人群抗谷氨酸脱羧酶抗体阳性波动性及其与糖尿病的相关性研究  

Fluctuation of glutamic acid decarboxylase antibody positivity and its correlation with diabetes in general adult population

作　　者：李婧[1] 林松柏[1] 邓垂文[2] LI Jing;LIN Song-bai;DENG Chui-wen(Department of Health Sciences,Peking Union Medical College Hospital,Beijing100730,China;Peking Union Medical College Hospital,Beijing100730,China)

机构地区：[1]北京协和医院健康医学部,北京100730 [2]北京协和医院,北京100730

出　　处：《实用预防医学》2021年第11期1299-1302,共4页Practical Preventive Medicine

基　　金：中国医学科学院医学与健康科技创新工程(CIFMS-2018-IZM-AI-005)。

摘　　要：目的研究普通成年人群抗谷氨酸脱羧酶抗体(glutamic acid decarboxylase antibody, GADA)阳性波动的发生率及其临床意义。方法检索北京协和医院健康管理数据库,分析2014—2019年进行过两次以上GADA检测成年人的阳性变化情况及其与糖尿病的相关性。结果共5 736人纳入研究,50人(0.9%)的GADA曾经阳性过,持续阳性12人,波动阳性38人。第一次检测阳性的20人40%后来抗体转阴。持续阳性者的GADA滴度为85.5(35.5,835.0)IU/ml,高于波动阳性者的滴度12.9(11.3,15.0)IU/ml,差异有统计学意义(P<0.001)。与GADA持续阴性组比,GADA曾经阳性组的体重指数、低密度脂蛋白胆固醇、甘油三酯、尿酸水平更低,高密度脂蛋白胆固醇水平更高,差异有统计学意义。GADA持续阳性和波动阳性组之间各临床指标差异无统计学意义。糖尿病患病的单因素分析和多因素logistic回归结果均提示GADA阳性不是糖尿病患病的风险因素。男性、年龄增长、体重指数增加、甘油三酯升高、高密度脂蛋白胆固醇降低、尿酸降低和高血压是糖尿病患病的独立风险因素。结论我国普通成年人群中的GADA阳性有较大转阴的可能。成年人群中GADA波动阳性和持续阳性者在临床表现上没有显著差异,GADA阳性可能不是糖尿病患病的独立风险因素。Objective To investigate the incidence rate of fluctuation of glutamic acid decarboxylase antibody(GADA) positivity and its clinical significance in general Chinese adults. Methods We searched the PUMCH-HM database for adult participants who had two or more GADA tests from 2014 to 2019. The changing status of GADA positivity and its association with diabetes were analyzed. Results A total of 5,736 participants were enrolled in this study. 50(0.9%)participants tested positive for GADA at least once, GADA positivity persisted in 12 participants and fluctuated in 38 ones. Of the 20 participants with positive GADA in the first test, 40% became negative. The GADA titers of persistent positive participants(85.5(35.5, 835.0) IU/ml) were higher than those of fluctuant positive ones(12.9(11.3, 15.0) IU/ml), with a statistically significant difference(P<0.001). The participants with GADA positive once had significantly lower body mass index, low-density lipoprotein cholestein, triglyceride and urine acid and higher high-density lipoprotein cholestein compared with those with persistent negative GADA, showing statistically significant differences. No statistically significant differences were found in the clinical indicators between persistent GADA positive group and fluctuant GADA positive group. Single factor and multivariable logistic regression analyses revealed that GADA positivity was not a risk factor for presence of diabetes. Male, increasing age, higher body mass index, higher triglyceride, lower high-density lipoprotein cholestein, lower urine acid and hypertension were independent risk factors for presence of diabetes. Conclusion GADA positivity in general Chinese adults is far more likely to become negative. No significant differences are observed in the clinical indicators between persistent GADA positive group and fluctuant GADA positive group. GADA positivity may be not an independent risk factor for presence of diabetes.

关 键 词：糖尿病 抗谷氨酸脱羧酶抗体 自身免疫性疾病 多因素logistic回归 

分 类 号：R587.1[医药卫生—内分泌]