IAA、ICA和GADA的年龄分布及与临床指标的关系研究

目的分析抗胰岛素抗体(IAA)、抗胰岛细胞抗体(ICA)和抗谷氨酸脱羧酶抗体(GADA)在患者中的分布情况及实验室指标的变化,探讨三种糖尿病相关抗体对疾病发生、发展变化的预示价值,为疾病治疗提供依据。方法分析2008-2018年在四川大学华西医院联合检测了IAA、ICA和GADA三种抗体患者的相关信息。将抗体阳性患者分为3个不同的年龄组(<40岁、40~59岁、>59岁),比较抗体检测结果组合在各年龄组间分布差异,分析抗体阳性患者疾病分布情况。以抗体阳性分组,分析三种抗体单项阳性组(单阳组)患者实验室指标检测结果的差异。结果三种抗体在不同年龄组间的分布差异无统计学意义(P>0.05);糖尿病患者人群IAA抗体单项阳性占65.08%;三种抗体主要存在于糖尿病患者中(占92.03%),其他疾病(如癌症、低血糖、系统性红斑狼疮)患者也可出现。碱性磷酸酶在IAA单阳组中的水平显著低于ICA单阳组(P<0.05);尿酸和肌酐在IAA单阳组中的水平显著高于GADA单阳组(P<0.05);球蛋白和肾小球滤过率在IAA单阳组水平显著低于GADA单阳组(P<0.05);空腹胰岛素在IAA单阳组水平显著高于ICA和GADA单阳组(P<0.05)。结论IAA、ICA和GADA三种抗体在各年龄组分布相近。IAA可作为糖尿病抗体检测的首选指标,IAA阳性糖尿病患者更应该注意其并发肾功能损害的风险。

Study on the age distribution of IAA,ICA and GADA and their relatimship with clincal indicators

Objective To analyze the distribution of anti insulin antibody(IAA),anti islet cell antibody(ICA)and anti glutamic acid decarboxylase antibody(GADA)in patients and the changes of laboratory indexes,and to explore the predictive value of three kinds of diabetes related antibodies for the occurrence and development of diseases,so as to provide basis for disease treatment.Methods The information of patients with IAA,ICA and GADA were analyzed from 2008 to 2018 in West China Hospital of Sichuan University.The antibody positive patients were divided into three different age groups(<40 years old,40~59 years old,>59 years old),and the differences of antibody distribution among different age groups were compared;the disease distribution of antibody positive patients was analyzed;the differences of laboratory marker test results of three antibody positive groups were analyzed.Results There was no significant difference in the distribution of the three antibodies among different age groups(P>0.05);65.08%of the diabetics were single positive IAA antibodies;the three antibodies mainly existed in the diabetics(92.03%),and other diseases(such as cancer,hypoglycemia,systemic lupus erythematosus)were also found.The level of alkaline phosphatase in single-positive IAA group was significantly lower than that in single-positive ICA group(P<0.05);the levels of uric acid and creatinine in single-positive IAA group were significantly higher than that in single-positive GADA group(P<0.05);the levels of globulin and glomerular filtration rate in single-positive IAA group were significantly lower than that in single-positive GADA group(P<0.05);the level of fasting insulin in single-positive IAA group was significantly higher than that in single-positive ICA and GADA group(P<0.05).Conclusion The distribution of IAA,ICA and GADA in different age groups are similar.IAA can be used as the first index of diabetes antibody detection,IAA positive diabetic patients should pay more attention to the risk of renal impaimment.