胰岛细胞自身抗体,抗谷氨酸脱羧酶抗体在初诊2型糖尿病？…

为筛查混淆于２型糖尿病中的成人隐匿性自身免疫性糖尿病，作者对７６例初诊为２型糖尿病患者进行胰岛细胞自身抗体和抗谷氨酸脱羧酶抗体检测，并同时检测１０名正常人与１０例慢性淋巴细胞性甲状腺炎患者作为对照。     

糖尿病检测谷氨酸脱羧酶抗体、胰岛细胞抗体和胰岛素自身抗体的临床意义

探讨血清谷氨酸脱羧酶抗体(GAD-Ab)、胰岛细胞抗体(ICA)和胰岛素自身抗体(IAA)检测对糖尿病(DM)的临床意义。对46例1型糖尿病(DM1)、78例2型糖尿病(DM2)和50名对照组应用增敏化学发光免疫分析法、RIA法检测其血清中GAD-Ab、ICA和IAA的阳性率并进行分组分析。结果表明DM1组GAD-Ab、ICA和IAA阳性率分别为67.39%、39.13%和23.91%,三者联合检测阳性率为91.30%,均显著高于DM2组(P<0.01)及对照组(P<0.01);DM2组GAD-Ab、ICA和IAA阳性率分别为8.97%、15.39%和10.26%,三者联合检测的阳性率为29.49%,也显著高于对照组(P<0.01)。结论是血清GAD-Ab、ICA和IAA的检测对DM的分型、指导临床用药以及判断预后具有重要的临床应用价值。     

谷氨酸脱羧酶在胰岛细胞抗体检测中的意义

近年发现胰岛细胞抗体（ICA）存在异质性。谷氨酸脱羧酶（GAD）抑制试验可以将其划分为三种亚型：完全抑制,完全未抑制及部分抑制。对31例ICA、GAD双阳性的病人进行GAD抑制试验,3／18例1型糖尿病、2／9例LADA、4／4例非1型糖尿病（2型糖尿病2例、Graves病1例,多腺体自身免疫综合征1例）GAD抑制试验阳性,1型糖尿病组（急性发病1型糖尿病和LADA）ICA活性多不被GAD抑制,非1型糖尿病组中ICA被GAD抑制,P＜0．05。GAD抑制试验可列为ICA检测的伴随项目。     

胰岛细胞抗体、谷氨酸脱羧酶抗体阳性糖尿病患者临床分析

目前认为糖尿病是一种高度异质性的内分泌代谢疾病 ,其异质性表现在两方面 :1 临床表现高度异质性。 2 遗传性存在高度异质性。本文从临床角度着手 ,对胰岛细胞抗体(ＩＣＡ)、谷氨酸脱羧酶抗体 (ＧＡＤＡ)分别阳性或均阳性 ,阴性的糖尿病患者进行临床分析以探讨ＩＣＡ、ＧＡＤＡ的阳性患者临床特点。对象和方法一、对象 :所有患者均为在我院门诊和住院的成年病人 ,均符合 1989年ＷＨＯ制定的糖尿病诊断标准 ,起病半年内无酮症发生 ,对这类患者进行血ＩＣＡ、ＧＡＤＡ检测 ,并据检测结果随机抽取ＧＡＤＡ阳性者 4 0例、ＩＣＡ阳性者 4 0例 ,…     

谷氨酸脱羧酶抗体、胰岛细胞自身抗体联合检测早期诊断成人迟发性自身免疫性糖尿病

目的 探讨谷氨酸脱羧酶抗体(GADA)与胰岛细胞自身抗体(ICA)的联合检测,早期诊断成人迟发性自身免疫性糖尿病.方法 采用ELISA法对358例糖尿病患者的血清进行GADA与ICA的联合检测.将患者分为两组,A组为胰岛素依赖性(1型)糖尿病患者组,B组为2型糖尿病患者组,比较两组患者的检测结果.结果 1型糖尿病患者组GADA阳性率为52.34%,ICA阳性率为30.84%(P<0.005)明显高于2型糖尿病组(GADA阳性率为26.77%,ICA阳性率为13.39%).GADA与ICA联合检测,则1型糖尿病组的阳性率为69.56%,2型糖尿病组为24.62%.结论 GADA在1型糖尿病患者血清中有较高的阳性率,可作为1型糖尿病的免疫诊断指标,GADA与ICA的联合检测可提高1型糖尿病的检出率.对2型糖尿病而言,GADA、ICA各有一定的阳性率,其联合检测,可提高成人隐匿性自身免疫性糖尿病(LADA)的及早筛出与治疗,并为临床及早应用胰岛素治疗,以保护残存的胰岛β细胞功能提供了依据.     

谷氨酸脱羧酶抗体和胰岛细胞抗体在IDDM诊断中的价值

用放射免疫法测定７９例胰岛素依赖型糖尿病（ＩＤＤＭ）和５３例非胰岛素依赖型糖尿病（ＮＩＤＤＭ）病人的血清谷氨酸脱羧酶（ＧＡＤ）抗体，用ＥＬＩＳＡ法测定ＩＤＤＭ组的胰岛细胞抗体（ＩＣＡ）和胰岛素抗体（ＩＡＡ）。结果ＩＤＤＭ组ＧＡＤ抗体的阳性率为４６．８％，初发ＩＤＤＭ（病程不超出１年）与病程超出１年的ＧＡＤ抗体一率分别是６２．９％和３４．１％。ＮＩＤＤＭ及正常对照组未见阳性的ＧＡＤ体。ＩＣＡ和ＩＡＡ     

谷氨酸脱羧酶抗体、C-肽及胰岛素测定在糖尿病患者中的临床意义

目的:探讨谷氨酸脱羧酶(GAD)抗体、C-肽(CP)及胰岛素(INS)测定在糖尿病(DM)分型中的临 床意义。方法:采用放射免疫分析(RIA)检测27例1型糖尿病(DM1)患者及49例2型糖尿病(DM2)患者的 GAD抗体、CP及INS含量;采用糖电极法测定了上述对象的空腹血糖(FPG)。结果:GAD抗体阳性率DM1患 者为66.7%,与DM2患者8.2%相比,显著增高(P<0.01);DM1患者CP及INS水平均显著低于DM2患者(P <0.01)。结论:GAD抗体是胰岛β细胞功能损伤的一个预测指标,结合CP/FPG、INS/FPG对DM分型及治疗 有重要意义。     

糖尿病患者血清谷氨酸脱羧酶抗体的测定及其意义

目的：通过对谷氨酸脱羧酶抗体(GAD-Ab)的测定，了解其在糖尿病的诊断、分型和预测中的应用价值。方法：应用间接ELISA法测定43例Ⅰ型糖尿病患者血清谷氨酸脱羧酶(GAD)自身抗体，并以Ⅱ型糖尿病患者25例及正常人60例作对照。结果：Ⅰ型糖尿病患者的GAD-Ab阳性率高达76.74％(33/43)，Ⅱ型糖尿病患者为16％(4/25)，而正常人无1例阳性。结论：GAD-Ab对糖尿病的诊断、分型和预测具有应用价值。     

谷氨酸脱羧酶抗体与2型糖尿病口服耐药相关性研究

目的 探讨2型糖尿病口服降糖药耐药与血清谷氨酸脱羧酶抗体（GADA）的相关性。方法 将72例2型糖尿病患者根据口服降糖药治疗效果分成口服耐药组（31例,男18例,女13例）和口服药有效组（41例,男17例,女24例）,检测两组患者血中GADA、胰岛细胞抗体（ICA）、胰岛素抗体（IAA）,空腹及餐后血糖和C肽水平,糖化血红蛋白及体重指数。结果 体重指数和C肽水平口服耐药组明显低于口服药有效组（p〈0．005）,糖化血红蛋白及血糖,口服耐药组明显高于口服药有效组（p〈0．001）,口服耐药组GADA检出率明显高于口服药有效组（P〈0．05）,而两组间ICA、IAA检出率的比较无显著差别（p〉0．05）。结论 GADA在2型糖尿病口服耐药人群检出率较高,提示2型糖尿病人在疾病发展到一定程度后．胰岛β细胞的功能损伤可能与免疫因素有关,口服降糖药耐药现象仅是其表现形式。     

谷氨酸脱羧酶抗体在2型糖尿病患者中的检出率及分布特征

目的:观察谷氨酸脱羧酶抗体(GAD-Ab)在2型糖尿病(T2DM)患者中的检出率和分布特征。方法:采用ELISA检测1970例T2DM患者的GAD-Ab总检出率及GAD-Ab在不同性别、年龄、病程和体重指数(BMI)中的分布情况;用电化学发光法检测GAD-Ab阳性和阴性T2DM患者的空腹、餐后2h胰岛素(FINS、2hINS)和空腹、餐后2hC肽(FCP、2hCP)水平,并与健康人群比较。结果:1970例T2DM患者GAD-Ab阳性126例,总检出率为6.39%,GAD-Ab阳性主要分布在30～39岁年龄组(P<0.05),低BMI组检出率较高(P<0.05),不同病程组检出率无明显差异(P>0.05)。GAD-Ab阳性组T2DM FINS、2hINS、FCP和2hCP均低于GAD-Ab阴性组和健康对照组(P<0.05)。结论:GAD-Ab检测有助于临床对T2DM患者胰岛素功能变化进行评价。     

Association between BDNF Polymorphism and Depressive Symptoms in Patients Newly Diagnosed with Type 2 Diabetes Mellitus

PurposeLittle is known about the relationship between brain-derived neurotrophic factor (BDNF) gene polymorphisms and psychiatric symptoms in diabetes patients. We investigated the effects of BDNF Val/66/Met polymorphism, glucose status, psychological susceptibility, and resilience on anxiety and depression symptoms in patients newly diagnosed with type 2 diabetes mellitus (T2DM).Materials and MethodsWe examined biochemical factors and BDNF polymorphism in 89 patients who were newly diagnosed with T2DM. Psychiatric symptoms were investigated with the Hospital Anxiety and Depression Scale (HADS), and the Connor-Davidson Resilience Scale (CD-RISC) and Impact of Event Scale (IES) were used to assess psychological resilience and susceptibility to psychological distress, respectively. Logistic regression analyses were conducted to investigate factors associated with psychiatric symptoms.ResultsWe determined that 62 patients (70%) were Met-carriers. No significant differences were found between the Val/Val homozygous and Met-carrier groups regarding age, sex, body mass index, and clinical factors related to glycemic control and lipid profiles. HADS-anxiety and HADS-depression scores and IES factor scores were higher in the Met-carrier than the Val/Val homozygous group. Hemoglobin A1c (HbA1c) level was significantly inversely correlated with the severity of depressive symptoms. Resilience factors showed significant inverse correlations, and IES factors showed positive correlations with depressive symptom severity. In the logistic regression analysis model, depressive symptoms were significantly associated with HbA1c and BDNF polymorphism, whereas only the hyperarousal factor of the IES scale was associated with anxiety.ConclusionDepressive symptoms are associated with the presence of the Met-carriers and lower HbA1c in patients newly diagnosed with T2DM.     

降糖治疗对新诊断2型糖尿病血清色素上皮衍生因子的影响

目的 观察降糖治疗对新诊断的2型糖尿病患者血清色素上皮衍生因子水平的影响。方法 选取2009年2月~2011年6月新诊断且在重庆医科大学附属第一医院住院治疗的2型糖尿病患者47例,经过短期胰岛素强化治疗后,将患者随机分为以二甲双胍为基础的口服药物组（OAD组）26例和甘精胰岛素组（GLA组）21例,以空腹血糖＜7.2 mmol/L为治疗目标,降糖治疗6个月后,观察两组患者治疗前后血清PEDF 浓度、空腹血糖、HbA1c、HOMA-β、HOMA-IR水平。结果 经过6个月的降糖治疗,与基线比较,两组患者空腹血糖、HbA1C均降低,HOMA-β、PEDF均升高,差异有统计学意义（P＜0.05）;两组间空腹血糖、HbA1c、HOMA-β、PEDF比较,差异无统计学意义（P＞0.05）;HOMA-IR与基线比较,差异无统计学意义（P＞0.05）,两组间HOMA-IR比较,差异有统计学意义（P＜0.05）。结论 以二甲双胍为基础的口服药物降糖治疗和甘精胰岛素降糖治疗均可显著升高2型糖尿病患者的血清PEDF水平。     

血清γ干扰素诱导蛋白-10、IL-8在初诊DM2中的表达及意义

目的:探讨炎症细胞因子γ干扰素诱导蛋白-10(IP-10)、白介素-8(IL-8)在2型糖尿病(DM2)患者中的表达及意义。方法:检测37例初诊DM2患者及健康人33例血清IP-10、IL-8浓度并予对照分析。结果:DM2组IP-10、IL-8浓度均显著高于健康人。结论:IP-10、IL-8在DM2发病中可能起一定作用。     

血清γ干扰素诱导蛋白-10、IL-8在初诊DM2中的表达及意义

目的：探讨炎症细胞因子γ干扰素诱导蛋白-10（IP-10）、白介素-8（IL-8）在2型糖尿病（DM2）患者中的表达及意义。方法：检测37例初诊DM2患者及健康人33例血清IP-10、IL-8浓度并予对照分析。结果：DM2组IP-10、IL-8浓度均显著高于健康人。结论：IP-10、IL-8在DM2发病中可能起一定作用。     

Immune Reactivity to GAD25 in Type 1 Diabetes Mellitus

While both isoforms of glutamic acid decarboxylase (GAD) function as important autoantigens in autoimmune diabetes mellitus--GAD65 in humans and GAD67 in the NOD mouse--GAD67 is not synthesized in human pancreatic islets and is thought not to be an autoantigen in human diabetes. We have recently shown, however, that human islets contain a GAD67 splice variant: GAD25. Given the evidence that GAD67 could be a key diabetogenic autoantigen in the NOD mouse and the high prevalence of GAD65 autoantibodies in human type 1 diabetes, it became important to ask whether there is also immune reactivity to GAD25 in type 1 diabetes--possibly implicating it in the pathogenesis of the disease--and whether GAD25 reactivity could, like GAD65 reactivity, function as a clinically useful marker for the disease. We also hypothesized that the presence of autoantibodies to the smaller splice variant could be a cause of the up to 30% prevalence of GAD67 autoreactivity associated with type 1 diabetes. We therefore analyzed GAD25 reactivity in 105 newly-diagnosed children with type 1 diabetes and 74 control subjects. While 14 (13%) of the diabetic subjects were positive for GAD67 autoantibodies, only 3 (3%) were positive for GAD25 reactivity, none of which were GAD67 antibody-positive. Analysis of reactivity to a GAD67 chimera was consistent with GAD67 binding activity being due to cross-reactive GAD65 antibodies. Immunostaining confirmed the presence of GAD25 in human islets, revealing GAD25-positive cells to be sparse. Our results indicate that autoreactivity to GAD25 is rare in newlydiagnosed type 1 diabetes and does not underlie GAD67 reactivity.     

1型糖尿病一级亲属GADA、IAA与ICA联检的临床意义

目的：探讨联检1型糖尿病（DM1）一级亲属谷氨酸脱羧酶抗体（GADA）、胰岛素自身抗体（IAA）和胰岛细胞抗体（ICA）的临床意义。方法：采用ELISA测定血清GADA、IAA及ICA。结果：一级亲属GADA、IAA、ICA的检出率均显著高于正常对照组，自身抗体联检的阳性率显著高于单抗体或双抗体阳性率。结论：联检可以提高DM1高危人群筛查的阳性率。     

初诊2型糖尿病患者甲状腺激素水平与糖代谢水平的关系研究

目的 探究初诊2型糖尿病(T2DM)患者甲状腺激素水平与糖代谢水平的关系及其临床价值.方法 选取2014年6月至2016年6月我院内分泌科收治的96例T2DM患者,测定所有患者甲状腺激素水平和糖代谢水平,采用Spearman相关分析其相关性.结果 不同性别在甲状腺激素水平及糖代谢指标及血脂指标差异不具有统计学意义(P＞0.05).随着FPG升高,TSH、T3等激素水平降低,差异具有统计学意义(P＜0.05).随着TSH水平升高,FPG、2h PG、HbA1c、HoMA-IR、TC和TG差异具有统计学意义(P＜0.05).FT3与BMI、FPG、2h PG、HbA1c呈负相关(r=-0.453、-0.522、-0.621、-0.461,P＜0.05),FT3、FT4和TSH与HoMA-IR呈正相关(r=0.861、0.701和0.746,P＜0.05),TSH与HbA1c呈负相关(r=-0.622,P＜0.05),TT3和TT4与BMI、FPG、2h PG、HbA1c、HoMA-IR、TC和TG无相关性(P＞0.05).结论 初诊2型糖尿病患者甲状腺激素水平对患者糖代谢水平评估具有重要意义.     

Association between Growth Differentiation Factor 15 (GDF15) and Cardiovascular Risk in Patients with Newly Diagnosed Type 2 Diabetes Mellitus

We investigated an association between serum Growth Differentiation Factor 15 (GDF15) level and cardiovascular risk in patients with newly diagnosed type 2 diabetes mellitus (T2D). A total of 107 participants were screened for T2D and divided into a T2D group and a control group (without diabetes). We used the Framingham risk score (FRS) and the New Pooled Cohort Equation score to estimate the 10-year risk of atherosclerotic cardiovascular disease. Serum GDF15 levels were measured using an enzyme-linked immunosorbent assay. Correlation analyses were performed to evaluate the associations between GDF15 level and cardiovascular risk scores. The mean serum GDF15 level was elevated in the T2D group compared to the control group (P < 0.001). A positive correlation was evident between serum GDF15 level and age (r = 0.418, P = 0.001), the FRS (r = 0.457, P < 0.001), and the Pooled Cohort Equation score (r = 0.539, P < 0.001). After adjusting for age, LDL-C level, and body mass index (BMI), the serum GDF15 level was positively correlated with the FRS and the New Pooled Cohort Equation score. The serum GDF15 level is independently associated with cardiovascular risk scores of newly diagnosed T2D patients. This suggests that the level of GDF15 may be a useful predictive biomarker of cardiovascular risk in newly diagnosed T2D patients.