谷氨酸脱羧酶抗体在临床初诊2型糖尿病病程中的演变

目的观察谷氨酸脱羧酶抗体(GADAb)在临床初诊2型糖尿病(T2DM)病程中的变化情况。方法在我院内分泌科连续入组病程1年以内的初诊T2DM患者共303例。每半年或1年复查GADAb,每年复查空腹C肽,每3个月检测糖化血红蛋白。随访1~6(中位数1·2)年。结果入组时GADAb阴性的265例患者随访2年内保持阴性不变;38例GADAb阳性,随访结束时16例转阴;5例表现为抗体阳性→阴性→阳性波动;17例始终保持抗体阳性。GADAb整体上随病程发展其滴度减低(P<0·05),且其变化仅与初始抗体滴度呈负相关(P<0·01)。结论GADAb在临床初诊T2DM病程中存在变化。单次检测GADAb有可能漏诊自身免疫性糖尿病。

The evolution of glutamic acid decarboxylase antibodies during the course of newly diagnosed type 2 diabetes mellitus

Objective To study the variability of the glutamic acid decarboxylase antibody(GADAb)of newly-onset type 2 diabetic patients. Methods Three hundred and three newly-diagnosed type 2 diabetic patients with less than one year duration were continuously sampled. GADAb were tested every half or one year. The average follow-up duration was 1.2 years. Results (1) Those GADAb-negative cases did not convert throughout the following-up. (2) Among the 38 cases who had positive GADAb at the beginning, 16 cases changed into GADAb negative at the end of following up, 5 cases switched between GADAb positive and negative, and other 17 cases remained GADAb negative all the time. Conclusions There are four different trends of the evolution of the GADAb levels in newly-onset type 2 diabetes mellitus: maintaining negative or positive, changing positive into negative, or negative into positive.