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研究血清胰岛细胞抗体(ICA)、谷氨酸脱羧酶(GAD)抗体检测在2型糖尿病病人中筛查出成人缓慢进展性自身免疫性糖尿病(LADA)的临床价值。方法:比较了LADA46例、ICA、GAD抗体阴性的2型糖尿病35例及成人1型糖尿病17例的临床特点,血糖、血脂、胰岛素、C肽水平等。结果:LADA组GAD抗体阳性率为93.5％,明显高于ICA(47.8％),除自发酮症外,血糖、血脂、胰岛素、C肽水平与2型糖尿病并无显著差异。随病程的延长,8细胞功能的减退并不显著。结论:LADA诊断虽依赖于ICA、GAD抗体测定,但早期胰岛素应用与否应根据个体化而定。
To investigate the clinical value of detecting serum islet cell antibody (ICA) and glutamic acid decarboxylase (GAD) antibody in screening patients with type 2 diabetes mellitus with slowly progressive autoimmune diabetes mellitus (LADA). Methods: The clinical features of 46 cases of LADA, 35 cases of type 2 diabetes mellitus with ICA, GAD antibodies and 17 cases of type 1 diabetes mellitus were compared. The levels of blood glucose, blood lipids, insulin and C-peptide were compared. Results: The positive rate of GAD antibody in LADA group was 93.5%, which was significantly higher than that in ICA (47.8%). There was no significant difference in blood glucose, lipids, insulin, C peptide levels and type 2 diabetes mellitus except for spontaneous ketosis. With the extension of the course, the decline of 8-cell function was not significant. Conclusion Although LADA diagnosis relies on the determination of ICA and GAD antibodies, the early application of insulin should be based on individualization.