急性起病糖尿病患者 HLA-DQ 易感基因型与胰岛功能的相关性研究

目的探讨南京地区急性起病糖尿病患者HLA—DQ易感基因型-9胰岛功能及胰岛自身抗体的相关性。方法收集2006—2008年期间南京鼓楼医院内分泌科收诊的急性起病糖尿病患者150例。DNA测序法确定HLA—DQAl和DQBl基因型,检测不同易感基因型下急性起病糖尿病患者的胰岛功能和胰岛自身抗体。结果急性起病糖尿病患者中,①高危基因型组IA～2Ab、GADA阳性率显著均高于中危基因型组（均P〈0．05）;IA-2Ab阳性率亦显著高于低危基因型组（P〈0．05）。②IA-2Ab单一阳性患者的高危基因型分布频率显著高于低危基因型和中危基因型（均P〈0．05）,GAD—Ab单一阳性患者的高危基因型分布频率显著高于中危基因型（P〈0．05）。③同时携带DQAl（高危）和DQBl（低危）基因型患者的C肽水平显著低于同时携带DQAl（低危）和DQBl（低危）基因型的患者（均P〈0．05）。结论与携带低危基因型的急性起病糖尿病患者比较,携带HIJA—DQ高危基因型的患者体内胰岛自身免疫反应更重,C肽水平更低。因此,对急性起病糖尿病患者进行HLA—DQ易感基因型的筛查将有助于患者的病情评估。

The correlation of HLA-DQ susceptible genotypes and functions of islet in patients with acuteonset diabetes

Objective To explore the correlation between HLA-DQ risk alleles and islet functions as well as islet antoantibody in patients with acute onset diabetes in Nanjing region. Methods One hundred fifty patients with acute onset diabetes admitted to the department of eudocrinology,Nanjing Drum Tower Hospital,from 2006 to 2008 were recruited. HLA-DQA1 and DQB1 genes were se- quenced and functions of islet, as well as auto-antibody in acute onset diabetic patients under varied risk alleles were determined. Re-suits In patients with acute onset diabetes, positive rates of IA- 2Ab and GADA in the high-risk genotype group were significantly higher than that in the medium-risk genotype group （P 〈 0. 05）, and positive rate of IA-2Ab in the high-risk genotype group was signifi- cantly higher than that in the low-risk genotype group （ P 〈 0.05 ）. distribution frequency of high-risk genotype in patients with IA- 2Ab positive only was significantly higher than that of low-risk and medium-risk genotype （ P 〈 0.05 ）, and distribution frequency of high -risk genotype in patients with GAD-Ab positive only was significant-ly higher than that of medium-risk genotype （P 〈 0. 05）. he level of C peptide in patients carrying DQA1 （high-risk） and DQB1 （low-risk） genotypes was significantly lower than that in patients carrying DQA 1 （ low- risk ） and DQB 1 （ low- risk） genotypes （ P 〈 0. 05）. Conclusion Compared with acute onset diabetic patients carrying low-risk genotype, auto-reaction against pancreas in pa- tients carrying high-risk genotypes is more severe while C peptide level is lower. Therefore, the screening of I-ILA-DQ risk alleles in pa- tients with acute onset diabetes will be helpful for evaluation of the disease.