3种胰岛自身抗体与1型糖尿病患儿并发肾损害的关系研究  

Relationships between three islet autoantibodies and renal damage in children with type 1 diabetes mellitus

作　　者：刘建丽[1] 刘力铭[1] 杨晓莹[1] LIU Jianli;LIU Liming;YANG Xiaoying(Department of Pediatric Endocrinology,Tangshan Maternal and Child Health Care Hospital,Tangshan,Hebei,063000)

机构地区：[1]河北省唐山市妇幼保健院小儿内分泌科,河北唐山063000

出　　处：《实用临床医药杂志》2021年第21期119-123,共5页Journal of Clinical Medicine in Practice

基　　金：河北省卫生健康委员会资助项目(20201470)。

摘　　要：目的探讨血清锌转运体8自身抗体(ZnT8A)、谷氨酸脱羧酶抗体(GADA)及蛋白酪氨酸磷酸酶抗体(IA-2A)水平与1型糖尿病患儿并发肾损害的关系。方法选取123例1型糖尿病患儿纳入研究组,另选取同期体检的105例健康儿童纳入对照组,检测并比较2组血清ZnT8A、GADA及IA-2A水平。评估研究组患儿肾功能状态,根据肾损害并发情况将患儿分为并发组与未并发组,比较2组患儿血清ZnT8A、GADA、IA-2A阳性率,并采用Logistic多元回归分析法分析血清ZnT8A、GADA、IA-2A以及其他因素与1型糖尿病患儿并发肾损害的关系。结果研究组血清ZnT8A、GADA、IA-2A阳性率(41.46%、60.98%、45.53%)均高于对照组,差异有统计学意义(P<0.05);研究组肾损害并发率为38.21%(47/123),并发组血清ZnT8A、GADA、IA-2A阳性率(74.47%、85.11%、78.72%)均高于未并发组,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,1型糖尿病病程、胱抑素C(CysC)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、舒张压、血尿酸、血红蛋白(Hb)以及血清ZnT8A、GADA、IA-2A均是1型糖尿病患儿并发肾损害的影响因素(P<0.05)。结论1型糖尿病患儿血清ZnT8A、GADA、IA-2A阳性率高于健康儿童,且并发肾损害患儿的阳性率较未并发患儿高。血清ZnT8A、GADA、IA-2A阳性和糖尿病病程偏长、高CysC、高FBG、高HbA1c、高NAG、高血尿酸、高舒张压、低Hb均可增加1型糖尿病患儿并发肾损害的风险,临床医生需据此加强防控。Objective To explore the relationships between serum zinc transporter 8 autoantibody(ZnT8A),glutamic acid decarboxylase antibody(GADA),protein tyrosine phosphatase antibody(IA-2A)and renal damage in children with type 1 diabetes mellitus.Methods A total of 123 children with type 1 diabetes mellitus(study group)and 105 healthy children(control group)at same period were selected as study subjects,and the levels of serum ZnT8A,GADA and IA-2A were detected and compared between the two groups.The renal function of the children in the study group was evaluated,and the children were divided into complicated group and the non-complicated group according to the concurrent conditions of renal damage,and the positive rates of serum ZnT8A,GADA and IA-2A were compared between the complicated group and the non-complicated group.The relationships between the positive of serum ZnT8A,GADA,IA-2A and renal damage in children with type 1 diabetes mellitus were analyzed by Logistic multiple regression analysis.Results The positive rates of ZnT8A,GADA and IA-2A in the study group were 41.46%,60.98%and 45.53%,respectively,and were significantly higher than those in the control group(P<0.05).The complication rate of renal damage in the study group was 38.21%(47/123),and the positive rates of serum ZnT8A,GADA and IA-2A in the complicated group were 74.47%,85.11%and 78.72%,respectively,which were higher than those in non-complicated group(P<0.05).Multivariate Logistic regression analysis showed that the course of type 1 diabetes,cystatin C(CysC),fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),urinary N-acetyl-β-d-glucosaminidase(NAG),diastolic blood pressure,serum uric acid,hemoglobin(Hb)and serum ZnT8A,GADA and IA-2A were all risk factors for renal damage in children with type 1 diabetes(P<0.05).Conclusion The positive rates of serum ZnT8A,GADA and IA-2A in children with type 1 diabetes mellitus are significantly higher than those in normal children,and positive rates of children with renal damage complicating renal injury are

关 键 词：锌转运体8自身抗体 谷氨酸脱羧酶抗体 蛋白酪氨酸磷酸酶抗体 1型糖尿病 肾损害 

分 类 号：R587.1[医药卫生—内分泌] R692[医药卫生—内科学]