非胰岛素依赖糖尿病自身抗体和胰岛细胞功能的关系

目的探讨非胰岛素依赖糖尿病(NIDDM)三种主要自身抗体与胰岛细胞分泌功能之间的关系。方法对110例正常者和175例初诊为NIDDM的患者测定空腹及口服葡萄糖75克后2小时静脉血浆葡萄糖,胰岛素,C肽,胰高血糖素(分别简写为FPG、2hPG、Fins、2hIns、FCP、2hCP、FGCG、2hGCG),并计算其胰岛素敏感指数(ISI)。同时,测定NIDDM组血清中谷氨酸脱羧酶抗体(GAD-Ab)、胰岛素自身抗体(IAA)和胰岛细胞抗体(ICA),根据三种自身抗体再把NIDDM组分为全阴性、全阳性、GAD-Ab阳性、IAA阳性、ICA阳性5个亚组。观察初诊NIDDM组自身抗体的阳性率和自身抗体与胰岛细胞功能的关系。结果(1)NIDDM组GAD-Ab、IAA、ICA阳性率分别为29.1%(51/175)、31.4%(55/175)、18.3%(32/175)。(2)NIDDM组FCP、FGCG比对照组分泌增多,ISI降低(P分别为0.008、<0.001、<0.001)。(3)三种抗体全阳性、GAD-Ab阳性、IAA阳性、ICA阳性亚组的FCP均低于全阴性亚组(P<0.01)。其中全阳性亚组、GAD阳性和ICA阳性亚组的FGCG高于全阴性亚组(P分别为0.007、0.047、0.012)。结论在初诊的NIDDM患者中自身抗体阳性预示其胰岛B细胞功能受损。

The relation between non-insulin dependent diabetes mellitus (NIDDM)au-toantibodies and function of pancreatic islet cells

Objective To investigate the relation between three kinds of important autoantibodies and the Secretory function of pancreatic islet cells in NIDDM.Methods Plasma glucose,insulin,C-peptide and glucagon from fasting blood and2h after inges-tion of75g glucose abbreviated FPG,2hPG,Flns,FCP,2hCP,FGCG,2h GCG of110controls and175subjects with first visit NIDDM patients were determined and the in-sulin sensitivity index(ISI)calculated.At the same time,serum glutamic acid decarboxy-lase(GAD-Ab),islet cell antibodies(ICA),and insulin autoantibodies(IAA)in NIDDM patients were determined as well.Ac cording to all-autoantibodies-negative,all-autoanti-bodies-positive,GAD-Ab-positive,IAA-positive,and ICA-positive,The NIDDM-group were further divided into five subgroups.The frequency of three kinds of autoantibodies and the relation between au toantibodies and function of pancrestic islet cells were ob-served.Results(1)The fre quency of GAD-Ab,IAA,and ICA were29.1%(51/175),31.4%(55/175)and18.3%(18/175)re spectively.(2)FCP and FGCG levels in the NID DM patients were significant ly higher than those in the controls,but ISI was significant ly lower.(3)Fasting C-peptide level in the autoantibodies-positive subgroups,FGCG levels were sig nificantly higher.Conclu sion Autoantibodies-positive in the first visit NID DM patients indicates the dam age of B-cell function