2型糖尿病患者胰岛细胞自身抗体、抗谷氨酸脱羧酶抗体水平与糖尿病微血管并发症的关系  

Relationship between islet cell autoantibodies,anti-glutamic acid decarboxylase antibodies,and diabetic microangiopathy in Patient with type 2 diabetes

作　　者：殷晋华 杨晓燕[1] 李鹏丽[1] 张国恒 马吉鑫 李静[3] Yin Jinhua;Yang Xiaoyan;Li Pengli;Zhang Guoheng;Ma Jixin;Li Jing(Department of Clinical Laboratory,Taiyuan Hospital of Peking University/Taiyuan Central Hospital,Taiyuan 030009,China;Department of Clinical Laboratory,First Hospital of Shanxi Medical University,Taiyuan 030001,China;Department of Clinical Laboratory,Shanxi Cancer Hospital,Taiyuan 030013,China)

机构地区：[1]北大医院太原医院/太原市中心医院检验科,太原030009 [2]山西医科大学第一附属医院检验科,太原030001 [3]山西省肿瘤医院检验科,太原030013

出　　处：《保健医学研究与实践》2024年第5期60-64,84,共6页Health Medicine Research and Practice

基　　金：山西省基础研究计划项目(202203021222395)。

摘　　要：目的探讨抗胰岛细胞抗体(ICA)、抗胰岛素抗体(IAA)及抗谷氨酸脱羧酶抗体(GADA)与2型糖尿病(T2DM)患者发生糖尿病微血管并发症(DMAP)的关系。方法对2023年11月-2024年3月本院收治的114例T2DM患者临床资料进行回顾性分析,根据是否发生DMAP将患者分别分入单纯T2DM组(n=61)和并发症组(n=53)。检测所有患者入院时IAA、ICA及GADA水平。采用受试者工作特征(ROC)曲线分析IAA、ICA及GADA对DMAP的评估价值,采用多因素logistic回归分析探讨DMAP的影响因素。结果并发症组患者的ICA、IAA、GADA水平均高于单纯T2DM组,差异均有统计学意义(P<0.05)。ICA、IAA及GADA评估T2DM患者发生DMAP的曲线下面积(AUC)分别为0.792、0.736、0.805,联合检测的AUC为0.912。并发症组患者T2DM病程≥8年比例、有饮酒史比例均高于单纯T2DM组患者,差异均有统计学意义(P<0.05)。logistic回归结果显示:T2DM病程≥8年(OR=2.314,95%CI:1.136~4.714)、ICA≥4183.62 RU/mL(OR=4.221,95%CI:1.849~9.633)、IAA≥5587.37 RU/mL(OR=3.449,95%CI:1.654~7.192)、GADA≥3667.92 IU/mL(OR=5.150,95%CI:2.058~12.888)是T2DM患者发生DMAP的危险因素(P<0.05)。结论ICA、IAA及GADA与T2DM患者发生DMAP密切相关,联合检测有助于DMAP的评估。Objective To investigate the relationship between islet-cell antibodies(ICA),insulin autoantibodies(IAA),and glutamic acid decarboxylase antibodies(GADA)with diabetic microangiopathy(DMAP)in Patient with type 2 diabetes mellitus(T2DM).Methods A retrospective analysis was conducted on the clinical data of 114 T2DM patients admitted to our hospital from November 2023 to March 2024.Patients were assigned to two groups based on the occurrence of DMAP:the simple T2DM group(n=61)and the complication group(n=53).The levels of IAA,ICA,and GADA were detected upon admission for all patients.The receiver operating characteristic(ROC)curve analysis was used to assess the value of IAA,ICA,and GADA in evaluating DMAP,and multivariate logistic regression analysis was adopted to explore the influencing factors of DMAP.Results The levels of ICA,IAA,and GADA in the complication group were all higher than those in the simple T2DM group,with statistically significant differences(P<0.05).The areas under the curve(AUC)for ICA,IAA,and GADA in evaluating DMAP in T2DM patients were 0.792,0.736,and 0.805,respectively,and the AUC for combined detection was 0.912.The proportion of T2DM patients with a disease course of≥8 years and a history of alcohol consumption in the complication group was significantly higher than that in the simple T2DM group(P<0.05).Logistic regression results showed that a T2DM disease course of≥8 years(OR=2.314,95%CI:1.136-4.714),ICA≥4183.62 RU/mL(OR=4.221,95%CI:1.849-9.633),IAA≥5587.37 RU/mL(OR=3.449,95%CI:1.654-7.192),and GADA≥3667.92 IU/mL(OR=5.150,95%CI:2.058-12.888)are risk factors for DMAP in T2DM patients(P<0.05).Conclusion ICA,IAA,and GADA are closely related to the occurrence of DMAP in T2DM patients,and combined detection is helpful for the assessment of DMAP.

关 键 词：胰岛细胞自身抗体 抗谷氨酸脱羧酶抗体 2型糖尿病 微血管并发症 

分 类 号：R587.1[医药卫生—内分泌]