青州地区初次住院2型糖尿病患者胰岛自身抗体及功能测定的临床研究  

Clinical Study on Determination of Islet Autoantibody and Function in Type 2 Diabetes Patients Hospitalized for the First Time in Qingzhou Area

作　　者：钟燕 胡本玲 王焕伦 张建刚 ZHONG Yan;HU Benling;WANG Huanlun;ZHANG Jiangang(Department of Endocrinology,Qingzhou People's Hospital Affiliated to Shandong First Medical University(Qingzhou People's Hospital),Qingzhou,Shandong Province,262500 China;Department of Emergency,Qingzhou Hospital Affiliated to Shandong First Medical University(Qingzhou People's Hospital),Qingzhou,Shandong Province,262500 China)

机构地区：[1]山东第一医科大学附属青州医院(青州市人民医院)内分泌科,山东青州262500 [2]山东第一医科大学附属青州医院(青州市人民医院)急诊科,山东青州262500

出　　处：《糖尿病新世界》2023年第1期50-53,共4页Diabetes New World Magazine

摘　　要：目的通过对青州地区初次住院2型糖尿病患者进行胰岛自身抗体及胰岛功能测定,早期发现成人隐匿性自身免疫糖尿病(latent autoimmune diabetes in adults,LADA),分析其临床特点,指导治疗,改善患者预后。方法选取青州市人民医院2021年1月—2022年6月初次住院的426例2型糖尿病患者作为研究对象,进行空腹血糖(FPG)、糖化血红蛋白(HbA1c)、空腹C肽(FCP)、谷氨酸脱羧酶抗体(GADA)、胰岛细胞抗体(ICA)、胰岛素自身抗体(IAA)测定。统计LADA的发病率,与同期2型糖尿病(T2DM)患者进行相关指标比较,分析其临床特点。结果青州地区初次住院426例2型糖尿病患者中胰岛自身抗体阳性29例,LADA的发病率为6.81%;29例LADA中GADA26例,ICA6例、IAA3例、3抗体同时阳性2例,GADA、ICA、IAA分别占LADA患者的89.66%、20.69%、10.34%。LADA组空腹血糖明显高于T2DM组[(19.58±9.89)mmol/L vs(12.30±4.59)mmol/L],差异有统计学意义(t=4.02,P<0.001);HbA1c明显高于T2DM组[(11.08±2.55)%vs(9.64±2.16)%],差异有统计学意义(t=2.53,P<0.05);空腹C肽明显低于T2DM组[(0.33±0.38)ng/mL vs(2.35±1.15)ng/mL],差异有统计学意义(t=8.80,P<0.001);发病年龄明显低于T2DM组[(40.79±13.70)岁vs(50.79±13.70)岁],差异有统计学意义(t=4.34,P<0.001);体质指数明显低于T2DM组[(20.88±4.22)kg/m2 vs(25.09±3.92)kg/m2],差异有统计学意义(t=4.41,P<0.001)。结论青州地区初次住院2型糖尿病患者,LADA发生率为6.81%,LADA与T2DM患者相比,发病年龄小、体质指数低,空腹血糖、糖化血红蛋白高,胰岛β细胞功能更差。Objective To detect latent autoimmune diabetes mellitus in adults(LADA)early through the determination of islet autoantibodies and islet function in type 2 diabetes patients hospitalized for the first time in Qingzhou area,analyze its clinical characteristics,guide treatment,and improve the prognosis of patients.Methods 426 patients with type 2 diabetes who were hospitalized for the first time from January 2021 to June 2022 in Qingzhou People's Hospital were selected as subjects.Fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),fasting CDOI peptide(FCP),glutamic acid decarboxylase antibody(GADA),islet cell antibody(ICA)and insulin autoantibody(IAA)were determined.The incidence of LADA was statistically analyzed,and relevant indicators were compared with those of patients with type 2 diabetes mellitus(T2DM)at the same time to analyze its clinical characteristics.Results Among 426 patients with type 2 diabetes mellitus admitted for the first time in Qingzhou,29 cases were positive for islet autoantibody,and the incidence of LADA was 6.81%.Among the 29 cases of LADA,there were 26 cases of GADA,6 cases of ICA,3 cases of IAAand 2 cases of 3 antibody positive.Gada,ICA and IAA accounted for 89.66%,20.69%and 10.34%of LADA patients,respectively.Fasting plasma glucose in LADA group was significantly higher than that in T2DM group[(19.58±9.89)mmol/L vs(12.30±4.59)mmol/L],the difference was statistically significant(t=4.02,P<0.001);HbA1c was significantly higher than T2DM group[(11.08±2.55)%vs(9.64±2.16)%],the difference was statistically significant(t=2.53,P<0.05);fasting C-peptide was significantly lower than T2DM group[(0.33±0.38)ng/mL vs(2.35±1.15)ng/mL],the difference was statistically significant(t=8.80,P<0.001);the age of onset was significantly lower than that of T2DM group[(40.79±13.70)years vs(50.79±13.70)years],the difference was statistically significant(t=4.34,P<0.001);body mass index was significantly lower than that of T2DM group[(20.88±4.22)kg/m2 vs(25.09±3.92)kg/m2],the difference was stat

关 键 词：2型糖尿病 初次住院 胰岛自身抗体 空腹C肽 LADA 

分 类 号：R587.1[医药卫生—内分泌]