成人隐匿性自身免疫性糖尿病与2型糖尿病的检验指标差异分析  

Analysis of the Differences in Test Indicators between Occult Autoimmune Diabetes Mellitus and Type 2 Diabetes Mellitus in Adults

作　　者：薛春萍[1] 刘传江[1] 汪闯 赵显荣 XUE Chunping;LIU Chuanjiang;WANG Chuang;ZHAO Xianrong(Department of Laboratory,Macheng People's Hospital,Macheng,Hubei Province,438300 China)

机构地区：[1]湖北麻城市人民医院检验科,湖北麻城438300

出　　处：《糖尿病新世界》2023年第11期56-59,共4页Diabetes New World Magazine

基　　金：麻城市人民医院科技人才专项科研项目(【2021】10号文件)。

摘　　要：目的探讨成人隐匿性自身免疫性糖尿病(latent autoimmune diabetes in adults,LADA)与2型糖尿病(type 2 diabetes mellitus,T2DM)检验指标的差异。方法选取2021年1月—2022年5月湖北麻城市人民医院收治的初诊T2DM患者174例为研究对象,其中LADA患者30例(LADA组)、T2DM患者144例(T2DM组),检测谷氨酸脱羧酶抗体(GAD)、抗胰岛素细胞抗体(ICA)、抗蛋白络氨酸磷酸酶抗体(IA2)和胰岛素自身抗体(IAA),分析LADA组和T2DM组胰岛功能和代谢指标。结果LADA组GAD、IA2、ICA、IAA阳性率分别为56.67%、13.33%、36.67%、26.67%,明显高于T2DM组,差异有统计学意义(P<0.05);LADA组空腹血糖(FPG)、餐后2 h血糖(2 hPG)、高密度脂蛋白胆固醇(HDL-C)明显高于T2DM组,差异有统计学意义(P<0.05),LADA组C肽水平(FCP、1 hCP、2 hCP、3 hCP)明显低于T2DM组,差异有统计学意义(P<0.05)。两组尿糖、糖化血红蛋白、餐后1 h、3 h血糖、尿酸(UA)、超敏C反应蛋白(hs-CRP)、血脂(TG、TC、LDL-C、)血沉(ESR)等指标比较,差异无统计学意义(P>0.05)。结论LADA患者胰岛自身抗体阳性率明显高于单纯T2DM患者,FPG、2 hPG、HDL-C也明显高于T2DM患者。Objective To investigate the differences between the test indexes of Latent Autoimmune Diabetes in Adults(LADA)and Type 2 Diabetes Mellitus(T2DM).Methods From January 2021 to May 2022,174 patients with primary T2DM admitted to Macheng People's Hospital were selected for the study,including 30 patients with LADA(LADA group)and 144 patients with T2DM(T2DM group).Glutamic acid decarboxylase antibody(GAD),anti-insulin cell antibody(ICA),anti-protein complex phosphatase antibody(IA2)and insulin autoantibody(IAA)were detected,and islet function and metabolic indexes were analyzed in the LADA and T2DM groups.Results The positive rates of GAD,IA2,ICA and IAA in the LADA group were 56.67%,13.33%,36.67%and 26.67%,respectively,which were significantly higher than those in the T2DM group,the difference was statistically significant(P<0.05);Fasting plasma glucose(FPG),2 h postprandial plasma glucose(2 hPG),high-density lipoprotein cholesterol(HDL-C)in the LADA group were significantly higher than those in the T2DM group,the difference was statistically significant(P<0.05),and C-peptide levels(FCP,1 hCP,2 hCP,3 hCP)in the LADA group were significantly lower than those in the T2DM group,the difference was statistically significant(P<0.05).There was no statistically significant difference in urine glucose,glycosylated hemoglobin,1 h and 3 h postprandial glucose,uric acid(UA),ultrasensitive C-reactive protein(hsCRP),lipids(TG,TC,LDL-C)and blood sedimentation(ESR)between the two groups(P>0.05).Conclusion The positive rate of islet autoantibodies was significantly higher in patients with LADA than in patients with T2DM alone,and FPG,2 hPG,and HDL-C were also significantly higher than in patients with T2DM.

关 键 词：成人隐匿性自身免疫性糖尿病 自身抗体 胰岛功能检测 

分 类 号：R392[医药卫生—免疫学]