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谷氨酸脱羧酶抗体和胰岛细胞抗体联合检测对1型糖尿病早期诊断的意义 |
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董维平 张洪德 胡远峰 张爱芳 王丽娟 王煜非
【摘要】 目的 对984例糖尿病患者的胰岛细胞抗体(ICA)、谷氨酸脱羧酶抗体(GADA)和血清C肽进行了检测与分析，了解ICA和GADA阳性率以及阳性患者的胰岛功能情况，以明确ICA和GADA检测对1型糖尿病早期诊断的意义。方法 采用免疫组化法检测ICA，ELISA法定量检测GADA，放 射免疫法检测血清空 腹和餐后C肽。结果 ICA和(或)GADA阳性(阳性组)168例(17.0%)高于ICA阳性率(10.5%)和GADA阳性率(12.0%，P＜0.05)。成年患者GADA阳性率(10.5%)高于ICA(7.7%，P＜0.05)，青少年患者 ICA阳性率(46.5%)高于GADA(31.0%，P＜0.01)。抗体阳性患者的空腹和餐后C肽〔(325±368)pmol/L和(745±767)pmol/L〕明显低于抗体阴性患者〔(701±434)pmol/L和(1614±967)pmol/L,P＜0.001〕。结论 自身抗体阳性患者的胰岛功能明显低于阴性患者，提示自身抗体阳性患者胰岛功能有明显损伤。在成年糖尿病患者中GADA检测较ICA更为重要，而在青少年糖尿病患者中则ICA阳性率高于GADA。两种抗体的阳性结果常不一致，联合检测可提高诊断的敏感性，对1型糖尿病的早期诊断有重要意义。
【关键词】 谷氨酸脱羧酶 胰岛细胞 抗体 糖尿病，1型 诊断
Significance of combined determination of GADA and ICA in early diagnosis of type 1 diabetes mellitus
DONG Weiping,ZHANG Hongde,HU Yuanfeng,et al.Diabetes Research Laboratory,Shanghai First People s Hospital,200080
【Abstract】 Objective To evaluate the significance of islet cell antibody (ICA) and glutamic acid decarboxylase antibody (GADA) determination in the early diagnosis of type 1 diabetes mellitus, ICA, GADA and serum C-peptide of 984 patients with diabetes mellitus were measured and analysed. Methods ICA was determined with immunohistochemical method, GADA with enzyme-linked immunosorbent assay and serum C-peptide with radioimmunoassay. Results The positive rate of ICA and(or) GADA (positive group) was higher than that of ICA (17.0% versus 10.5%, P＜0.05) and that of GADA (17.0% versus 12.0%, P＜0.05). In adult diabetics, the positive rate of GADA was higher than that of ICA (10.5% versus 7.7%, P＜0.05), while in juvenile diabetics, the positive rate of ICA was higher than that of GADA (46.5% versus 31.0%, P＜0.01). Fasting and postprandial C-peptide of antibody positive diabetics 〔(325±368)pmol/L and (745±767)pmol/L〕 were significantly lower than those of antibody negative diabetics 〔(701±434)pmol/L and (1 614±967)pmol/L〕, P＜0.001. Conc[1] [2] [3] 下一页
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