1型糖尿病胰岛自身抗体与年龄和病程的关系

目的:比较1型糖尿病(type 1 diasetes,T1D)胰岛自身抗体阳性率与年龄和病程之间的关系?方法:对537例T1D患者检测其胰岛自身抗体,并收集一般信息和实验室检查结果,再将患者按年龄和病程进行分组,比较不同年龄和病程组患者胰岛自身抗体阳性率的差异?结果:537例患者平均年龄为(32.84 ± 17.98)岁,平均病程为4.31年?谷氨酸脱羧酶抗体(GADA)?蛋白酪氨酸磷酸酶抗体(IA-2A)?锌转运体8自身抗体(ZnT8A)和胰岛细胞抗体(ICA)的阳性率分别为54.4%?30.8%?28.2%和23.5%,至少1个抗体阳性率为75.4%?青春期前后的患者抗体阳性率分别为GADA 76.9% vs 57.4%(P=0.039),IA-2A 65.4% vs 31.7%(P=0.001),ZnT8A 38.5% vs 24.1%(P=0.108),至少1个抗体阳性83.3% vs 75.7%(P=0.014)?病程5年以内至少1个抗体阳性率为55.7%,而5年以上的阳性率为44.1%(P=0.032)?结论:随着T1D患者病程延长,抗体阳性率逐渐降低;患者年龄越小,抗体阳性率越高?因此对于成人T1D的诊断要应该更仔细,避免漏诊?

The association of islet autoantibodies with age and disease duration in type 1 diabetic patients

Objective:To identify the positive rate of islet autoantibodies in patients with type 1 diabetes (T1D) according to age and disease duration. Methods: We collected the general information and laboratory tests of 537 patients diagnosed with T1D,and measured the levels of islet autoantibodies. The subjects were subdivided into different groups according to their age and disease duration. Then we investigated the association of islet autoantibodies with age and disease duration. Results:Among 537 patients,the average age and disease duration was 32.84 ± 17.98 year-old and 4.31 years,respectively. 75.4% of patients were positive for at least one islet autoanbotidy(55.7% within 5 year of the disease onset:44.1% after 5 year,P=0.032). 54.4% of the patients were positive for glutamic acid decarboxylase antibody (GADA),30.8% for protein tyrosine phosphatase antibody (IA-2A),28.2% for zinc transporter 8 antibody(ZnT8A) and 23.5% for islet cell antibody (ICA). The positive rate was significantly higher in patient whose age was less than 12-year-old than in those over 12 (GADA 76.9% vs 57.4%,IA-2A 65.4% vs 31.7%,ZnT8A 38.5 % vs 24.1%,at least one islet autoanbotidy 83.3% vs 75.7%). Conclusion:The rates of positive islet autoantibodies significantly decreased along with the disease duration. Younger patients had higher rate of positive islet autoantibodies. Therefore,more attention should be paid when type 1 diabetes is diagenozed in adults.