广东惠州地区成人隐匿性自身免疫性糖尿病筛查及GADA滴度对其临床特征的影响  

Screening of latent autoimmune diabetes in adults in Huizhou,Guangdong and effects of GADA titers on their clinical characteristics

作　　者：彭林平[1] 万婷 罗浩元[3] 陈利强[1] Peng Linping;Wan Ting;Luo Haoyuan;Chen Liqiang(Endocrinology Department,Huizhou,Guangdong 516001,China;Nutrition Department,Huizhou,Guangdong 516001,China;Laboratory Department,Huizhou First People's Hospital,Huizhou,Guangdong 516001,China)

机构地区：[1]惠州市第一人民医院内分泌科,广东惠州516001 [2]惠州市第一人民医院营养科,广东惠州516001 [3]惠州市第一人民医院检验科,广东惠州516001

出　　处：《现代临床医学》2022年第4期257-260,共4页Journal of Modern Clinical Medicine

基　　金：惠州市医疗卫生类科技计划项目(2018Y074)。

摘　　要：目的:调查广东惠州地区成人自身免疫糖尿病(LADA)的发病情况,探讨不同谷氨酸脱羧酶抗体(GADA)滴度LADA患者的临床特征。方法:根据GADA滴度,将2017年7月至2020年7月在我院确诊的76例LADA患者分为低、中和高滴度组,分析不同滴度水平LADA患者临床特征的差异,并与35例GADA为阴性的T2DM患者的临床特征进行比较。结果:惠州地区成人糖尿病患者GADA阳性率高于多中心LADA China研究中南方地区的阳性率(7.45%vs 5.43%,P=0.02)。中、高滴度组改良胰岛素抵抗指数低于T2DM组(P<0.01);LADA各组的空腹血清C肽(FCP)水平均低于T2DM组(P<0.01),中、高滴度组FCP水平低于低滴度组(P<0.01)。结论:广东惠州地区成人糖尿病患者GADA阳性率较高,应重视对其GADA的筛查。低滴度LADA患者与T2DM患者存在相似的胰岛素抵抗,高滴度LADA患者病程早期易出现胰岛功能衰竭表现。Objective:To investigate the prevalence of latent autoimmune diabetes in adults(LADA)in Huizhou,Guangdong,and to explore the effect of glutamic acid decarboxylase antibody(GADA)titer on the clinical features of LADA patients.Methods:According to GADA titer,76 patients with LADA diagnosed in our hospital from July 2017 to July 2020 were divided into low,middle and high titer groups.The differences of clinical characteristics of LADA patients with different titers were analyzed,and their clinical characteristics were compared with 35 T2DM patients with negative GADA.Results:The positive rate of GADA in adults with diabetes mellitus in Huizhou was higher than that in South China in the multicenter LADA China study(7.45%vs 5.43%,P=0.02).Modified insulin resistance index in middle and high titer groups were lower than those in T2DM group(P<0.01);the level of fasting serum C-peptide(FCP)in each LADA group was lower than that in T2DM group(P<0.01),and the level of FCP in middle and high titer groups was lower than that in low titer group(P<0.01).Conclusion:The positive rate of GADA is high in adult patients with diabetes mellitus in Huizhou,Guangdong.We should attach importance to GADA screening.LADA patients with low titer have similar insulin resistance to T2DM patients,and those with high titer are prone to islet failure in the early stage of the disease.

关 键 词：成人隐匿性自身免疫性糖尿病 谷氨酸脱羧酶抗体 滴度 惠州 

分 类 号：R587.1[医药卫生—内分泌]