谷氨酸脱羧酶抗体检测在2型糖尿病早期诊断中的意义

目的探讨谷氨酸脱羧酶抗体(GAD-Ab)检测在2型糖尿病患者早期诊断中的意义。方法比较2型糖尿病患者GAD-Ab阳性组12例与阴性组86例的临床特征、体重指数、C肽、糖化血红蛋白等指标。结果GAD-Ab阳性组发病年龄低于阴性组,空腹及餐后2 h C肽值较低,使用胰岛素者比例较高,酮症酸中毒发生率高。结论检测2型糖尿病患者的GAD-Ab可帮助临床上早期发现迟发自身免疫糖尿病病人,尽早采用胰岛素治疗,对保护残存的胰岛功能有重要意义。

Value of glutamic acid decarboxylase autoantibody detection for early diagnosis of latent autoimmune diabetes in adults

Objective To study the diagnostic values of detection of glutamic acid decarboxylase antibody (GAD-Ab) for latent autoimmune diabetes in adults (LADA). Method The clinical characteristics, body mass index (BMI), serum C-peptide levels, and HbAIC were compared between the 12 type 2 diabetic patients positive and 86 negative for GAD-Ab. Results The mean age, BMI, fasting and postprandial 2 h C-peptide levels in GAD-Ab-positive group were lower than those of GAD-Ab-negative group. The frequency of insulin use and prevalence of ketosis were higher in GAD-Ab-positive group than in GAD-Ab-negative group. Conclusions The diagnosis of LADA can be established according to GAD-Ab-positivity, clinical characteristics and islet function. Patients with LADA should receive insulin therapy as early as possible to protect the residue islet B cells, reduce the occurrence of ketosis, and prevent diabetic complications of the eye, kidney and nerves.