自身抗体和细胞因子与成人隐匿性自身免疫糖尿病亚型的关系

目的探讨谷氨酸脱羧酶抗体(GADA)和胰岛细胞抗体(ICA)水平检测和细胞因子检测在成人隐匿性自身免疫糖尿病(LADA)诊断中的临床价值,并探索LADA患者两种不同亚型的特点。方法对500例临床诊断为2型糖尿病患者用酶免法进行GADA、ICA和细胞因子测定。结果GADA在2型糖尿病中的阳性率为11%,同时伴高血压、肥胖等,与2型糖尿病相似,为LADA-2 型糖尿病。ICA在2型糖尿病中的阳性率为9.6%,同时伴有起病年龄小、胰岛功能差、需要使用胰岛素治疗等临床症状,类似1型糖尿病,为LADA-1型糖尿病。细胞因子对GADA、ICA有促进作用,两者呈正相关。结论LADA存在LADA-1型和LADA-2型两种亚型,GADA、ICA和细胞因子测定对LADA诊断有重要临床价值。

Association of autoantibody and cytokines with latent autoimmune diabetes in adults

Objective To assess the clinical value of detecting glutamic acid decarboxylase antibody (GADA), islet cellantibody (ICA) and cytokines in the diagnosis of latent autoimmune diabetes in adults (LADA), and define the characteristicsof the two different types of LADA. Methods A total of 500 patients with an initial diagnosis of type 2 diabetes mellitus (T2DM) were tested for GADA, ICA and cytokines by enzyme-linked immunosorbent assay. Results In type 2 diabeticpatients approximately 11% were positive for GADA, who had similar symptoms as hypertension, hyperlipidemia and otherdiabetic complications to justify the diagnosis of LADA-2 subtype. Another 9.6% of the total patients were ICA-positive, andwhen compared with T2DM, these patients had similar clinical findings typical of type 1 diabetes such as younger age ofonset,impairedbetacellfunctionanddependenceoninsulintreatment.Thereforetheyhadmoreresemblancetoinsulin-dependent diabetes and can be diagnosed as having LADA-1 subtype. It was also found that cytokines positively actedon GADA and ICA, showing positive correlation between them. Conclusion LADA has LADA-1 and LADA-2 subtypes, andGADA, ICA and cytokines test have important clinical significance for diagnosis of LADA.