唾液中差异性蛋白在2型糖尿病早期诊断中的临床研究

目的：探讨唾液中的胱抑素C（Cys‐C）、α2‐巨球蛋白（α2‐MG）、α1‐抗胰蛋白酶（A1AT）及转甲状腺素蛋白（TTR）在2型糖尿病早期诊断中的临床意义及运用。方法选取体检正常人群38例（正常组），空腹血糖升高患者23例（IFG组），糖耐量患者31例（IGT组）及2型糖尿病患者86例（2‐DM组），通过免疫印迹检测4组人群唾液中Cys‐C、α2‐MG、A1AT 及TTR蛋白的表达并进行半定量分析。同时通过ELISA方法对唾液及血液中Cys‐C、α2‐MG、A1AT及TTR进行定量分析后研究其相关性。同时，根据 ELISA 定量结果对Cys‐C、α2‐MG、A1AT 及TTR绘制ROC曲线，确定各指标检测的特异性和灵敏度。结果免疫印迹条带进行半定量及ELISA定量检测均表明2‐DM 组患者唾液中 Cys‐C、α2‐MG、A1AT 明显上调，而 TTR蛋白无明显变化。唾液及血液中 Cys‐C、α2‐MG、A1AT及 TTR呈正相关，且唾液中Cys‐C、α2‐MG与血液中血糖浓度呈正相关。ROC曲线表明唾液中Cys‐C、α2‐MG可作为2‐DM早期诊断标志物。结论通过唾液中Cys‐C、α2‐MG的检测，可在2‐DM 早期进行筛查，并在糖尿病早期予以干预治疗，具有潜在的临床运用价值。

Clinical Study on Different Proteins in Saliva for Early Diagnosis of Type 2 Diabetes

Objective To study the clinical significance and application of Cys C ,α2‐MG ,A1AT and TTR in saliva for early diagnosis of type 2 diabetes .Methods The protein expressions of Cys C ,α2‐MG ,A1AT and TTR in the saliva of 38 normal cases ,23 patients with IFG ,31 patients with IGT and 96 patients with type 2 diabetes were tested by Western‐blotting analysis and the proteins were semi‐quantitatively analyzed .At the same time , CysC ,α2‐MG ,A1AT and TTR in saliva and serum were detected by ELISA for quantitative analysis and further correlation study .ROC curves of Cys C ,α2‐MG ,A1AT and TTR were drawn according to the quantitative results of ELISA and the specificity and sensitivity of each detection were determined .Results There were significant increase in Cys C ,α2‐MG and A1AT ,but no significant changes in TTR protein in saliva of patients with type 2 diabetes according to the results of Western‐blotting test and ELISA detection .Cys‐C ,α2‐MG ,A1AT and TTR in saliva and serum were positively correlated with each other , and Cys‐C and α2‐MG in saliva were positively correlated with blood glucose concentration .ROC curves showed that Cys C and α2‐MG in saliva could be used as early diagnostic markers of type 2 diabetes .Conclusion The detection of Cys C and α2‐MG in saliva has potential clinical significance in the early screening of Type 2 diabetes and clinical value in preventing and treating diabetes in the early stage .