摘要
目的 探讨磺脲类降糖药继发失效 (SF)患者中成人隐匿性自身免疫糖尿病 (LADA)的患病率及其临床特点。 方法 在SF组 (n =2 38)中筛查谷氨酸脱羧酶抗体 (GAD Ab)和胰岛细胞抗体 (ICA) ,并将之与非继发失效 (NSF)组 (n =110 )中的阳性率比较。 结果 SF组中GAD Ab阳性的LADA的患病率为 13.9%( 33 2 38) ,NSF组为 10 .0 %( 11 110 ) ,两组差异无显著意义 (P >0 .0 5 )。LADA患者体重指数低于GAD Ab阴性者 (P <0 .0 1) ,发病年龄、血压、甘油三酯、C肽值均降低 (P <0 .0 5 )。联合检测GAD Ab和ICA ,SF组中LADA的患病率可达 2 2 .7%( 5 4 2 38) ,NSF中为 18.1%( 2 0 110 ) ,SF组与NSF组LADA患病率高于单独以GAD Ab检测 (P <0 .0 1)。 结论 SF的糖尿病患者中LADA的患病率较高。联合检测GAD Ab和ICA可提高LADA诊断的敏感性。
Objective To investigate the prevalence and clinical characteristics of LADA in patients with secondary sulfonylureas failure (SF) and compare the diagnostic sensitivities of LADA by GAD-Ab alone and the combined with ICA. Methods GAD-Ab and ICA were screened from sera of type 2 diabetic patients with SF (n=238) and NSF (n=110). GAD-Ab and ICA were respectively detected by radioimmunopreciptation assay and ELISA. Results The prevalences of LADA diagnosed by positive GAD-Ab in SF and NSF group were (33/238) 13.9% and (11/110) 10.0% respectively (P> 0.05). Compared with GAD-Ab negative group, BMI was significantly lower (P< 0.01), blood pressure, TG, C-peptide and age at onset of LADA were also lower (P<0.05). The prevalences of LADA in SF and NSF group screened by either GAD-Ab or ICA were (54/238) 22.7% and (20/110) 18.1% respectively (P>0.05), both of the prevalences were higher than those of LADA diagnosed only by positive GAD-Ab (P<0.005). Conclusion The prevalence of LADA in SF group is high. Combined detecting GAD-Ab and ICA can improve the diagnostic sensitivity of LADA. The clinical characteristics of LADA diagnosed by GAD-Ab alone and GAD-Ab /ICA in SF were similar.
出处
《中国糖尿病杂志》
CAS
CSCD
2003年第3期168-171,共4页
Chinese Journal of Diabetes
基金
湖南省卫生厅科研基金资助项目 ( 2 0 0 1- Z0 4)
