2型糖尿病患者血清抗体联合检测的临床意义  

Clinical Significance of combined Serum Antibody Detection in Patients with Type 2 Diabetes Mellitus

作　　者：叶红珍[1] 吴长蓉[1] 黄江山[1] 陈小明 YE Hongzhen;WU Changrong;HUANG Jiangshan;CHEN Xiaoming(The First Affiliated Hospital of Xiamen University,Xiamen,Fujian Province,361000 China)

机构地区：[1]福建省厦门市厦门大学附属第一医院,福建厦门361000

出　　处：《糖尿病新世界》2022年第12期56-59,63,共5页Diabetes New World Magazine

摘　　要：目的探究2型糖尿病(T2DM)患者血清抗谷氨酸脱羧酶抗体(GADA)、抗胰岛素抗体(IAA)、抗胰岛素细胞抗体(ICA)、蛋白酪氨酸磷酸酶抗体(IA-2A)、锌转运体8抗体(ZnT8)检测的价值和意义。方法选取2021年1—10月该院收治的2335例2型糖尿病(T2DM)患者为观察组,再选100名健康体检者为对照组。对其进行GADA、IAA、ICA、IA-2A、ZnT8自身抗体检测。对上述指标进行对比分析。结果TT2DM的血清GADA、IAA、ICA、IA-2A、ZnT8单一检测及联合检测的阳性率对比,观察组高于对照组,差异有统计学意义(P<0.05)。血清GADA、IAA、ICA、IA-2A、ZnT8联合检测T2DM的AUC为0.918(95%CI0.848~0.963)优于单一GADA、IAA、ICA、IA-2A、ZnT8检测,差异有统计学意义(P<0.05)。GADA、IAA、ICA、IA-2A、ZnT8检测阳性率为糖尿病发病影响因素,阳性率越高,糖尿病风险越高。血清GADA、IAA、ICA、IA-2A、ZnT8联合诊断阳性患者FPG、2 hPG、HbA1c水平低于阴性患者,差异有统计学意义(P<0.05)。结论糖尿病患者用血清抗谷氨酸脱羧酶抗体、抗胰岛素抗体、抗胰岛素细胞抗体、蛋白酪氨酸磷酸酶抗体和锌转运体8抗体检测,对检出成人隐秘性糖尿病具有确切价值,有助于疾病的鉴别诊断。Objective To investigate the serum anti-glutamate decarboxylase antibody(GADA),anti-insulin antibody(IAA),anti-insulin cell antibody(ICA)and protein tyrosine phosphatase antibody(IA-2A)in patients with type 2 diabetes mellitus(T2DM),the value and significance of zinc transporter 8 antibody(ZnT8)detection.Methods A total of 2335 patients with type 2 diabetes mellitus(T2DM)admitted to the hospital from January to October 2021 were selected as the analysis objects and regarded as the observation group.Another 100 healthy subjects were selected as the control group.GADA,IAA,ICA,IA-2A,ZnT8 autoantibodies were detected.Compare and analyze the above indicators.Results The positive rates of GADA,IAA,ICA,IA-2A and ZnT8 in serum of TT2DM were detected by single and combined detection were compared,the observation group was higher than the control group,the difference was statistically significant(P<0.05).The AUC of serum GADA,IAA,ICA,IA-2A and ZnT8 combined detection of T2DM was 0.918(95%CI 0.848~0.963),which was better than that of single GADA,IAA,ICA,IA-2A and ZnT8 detection,the difference was statistically significant(P<0.05).The positive rates of GADA,IAA,ICA,IA-2A,and ZnT8 were the influencing factors of diabetes.The higher the positive rate,the higher the risk of diabetes.The levels of FBG,2 hPG and HbA1c in patients with positive combined diagnosis of serum GADA,IAA,ICA,IA-2A and ZnT8 were lower than those in negative patients,the difference was statistically significant(P<0.05).Conclusion The detection of serum anti-glutamate decarboxylase antibody,anti-insulin antibody,anti-insulin cell antibody,protein tyrosine phosphatase antibody and zinc transporter 8 antibody in diabetic patients has a definite value in detecting latent diabetes in adults.It is helpful for the differential diagnosis of diseases.

关 键 词：成人隐匿性自身免疫性糖尿病 胰岛自身抗体 抗谷氨酸脱羧酶抗体 抗胰岛素抗体 抗胰岛细胞抗体 蛋白酪氨酸磷酸酶抗体 锌转运体8抗体 

分 类 号：R446[医药卫生—诊断学]