胰岛素自身抗体与C肽、谷氨酸脱羧酶抗体在鉴别诊断成人隐匿性自身免疫性糖尿病中的临床意义  

Clinical Significance of Insulin Autoantibodies, C-peptide and Glutamate Decarboxylase Antibodies in Differential Diagnosis of Latent Autoimmune Diabetes in Adults

作　　者：余茜琼 王志卫 黄昌伟 YU Qianqiong;WANG Zhiwei;HUANG Changwei(Department of Laboratory,Lianjiang County Hospital,Fuzhou,Fujian Province,350500 China)

机构地区：[1]连江县医院检验科,福建福州350500

出　　处：《糖尿病新世界》2023年第21期48-50,54,共4页Diabetes New World Magazine

摘　　要：目的探讨胰岛素自身抗体与C肽、谷氨酸脱羧酶抗体在鉴别诊断成人隐匿性自身免疫性糖尿病(latent autoimmune diabetes in adults,LADA)中的临床意义。方法选取2020年7月—2022年12月连江县医院收治的84例LADA患者作为观察组,另选取同期80例健康体检者、80例2型糖尿病患者作为对照1组、对照2组,分别以化学发光法测定胰岛素自身抗体、C肽、谷氨酸脱羧酶抗体水平(glutamate acid decarboxylase antibody,GAD-Ab)及统计阳性检出率,以受试者工作特征曲线(receiver operating characteristic curve,ROC)分析单一指标检测及联合检测诊断及鉴别疾病的价值。结果观察组胰岛素自身抗体、GAD-Ab高于对照1组、对照2组,C肽低于对照1组、对照2组,差异有统计学意义(P<0.05)。ROC曲线显示联合检测诊断价值和鉴别价值均更高。结论胰岛素自身抗体与C肽、GAD-Ab可用于LADA筛查,也可与2型糖尿病鉴别诊断,临床可加以借鉴并为后续治疗提供参考。Objective To investigate the clinical significance of insulin autoantibody,C-peptide and glutamate decar-boxylase antibody in the differential diagnosis of latent autoimmune diabetes in adults with latent autoimmune diabe-tes in adults(LADA).Methods 84 patients with LADA admitted to Lianjiang County Hospital from July 2020 to De-cember 2022 were selected as the observation group,and another 80 healthy physical examination subjects and 80 pa-tients with type 2 diabetes during the same period were selected as control 1 group and control 2 group.The levels of insulin autoantibody,C-peptide,glutamic acid decarboxylase antibody(GAD-Ab)and the positive detection rate were measured by chemiluminescence method.Receiver operating characteristic curve(ROC)was used to analyze the value of single indicator detection and combined detection in diagnosis and differentiation of disease.Results Insulin auto-antibody and GAD-Ab in observation group were higher than those in control 1 group and control 2 group,and C-peptide was lower than those in control 1 group and control 2 group,and the differencs were statistically sigificant(P<0.05).ROC curve showed that combined detection had higher diagnostic value and differential value.Conclusion Insu-lin autoantibodies,C-peptide and GAD-Ab can be used for LADA screening and differential diagnosis of type 2 dia-betes mellitus,which can be used for clinical reference and provide reference for follow-up treatment.

关 键 词：胰岛素自身抗体 C肽 谷氨酸脱羧酶抗体 成人隐匿性自身免疫性糖尿病 

分 类 号：R446.1[医药卫生—诊断学]