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目的探讨锌转运体8自身抗体(ZnT8A)、谷氨酸脱羧酶抗体(GADA)和酪氨酸磷酸酶抗体2(IA-2A)在1型糖尿病(T1DM)初发病后不同病程的变化。方法60例病程2年(每隔3月复诊)和75例病程5~10年(中位数6.9年)的T1DM患者于初发病和复诊时采集血清,用放免法检测ZnT8A、GADA和IA-2A水平。结果135例T1DM患者初发病时ZnT8A、GADA和IA-2A的检出率分别为35.6%(48/135),57.0%(77/135)和23.7%(32/135),三抗体联合检测总阳性率为70.4%(95/135)。病程2年的患者ZnT8A和IA-2A的滴度分别在发病后第15、18个月内下降了42.2%和44.8%,变化显著(P<0.001),其后下降不显著(P>0.05);GADA则无显著变化(P>0.05)。75例T1DM患者病程5-10年后,ZnT8A和IA-2A的水平下降了48.2%和54.1%,变化显著(P值均<0.001),而GADA则无显著变化(P>0.05)。结论ZnT8A和IA-2A水平在T1DM发病早期尤其是发病后18个月内随病程延长而显著降低,GADA则不随病程变化。
Objective To investigate the changes of zinc transporter 8 autoantibodies (ZnT8A), glutamic acid decarboxylase antibody (GADA) and tyrosine phosphatase antibody 2 (IA-2A) in the early course of type 1 diabetes mellitus (T1DM). Methods Totally 60 patients with T1DM who were followed up for 2 years (referral every 3 months) and 75 patients with 5 ~ 10 years (median 6. 9 years) were collected at the initial onset and follow-up, and the levels of ZnT8A, GADA and IA- 2A level. Results The detection rates of ZnT8A, GADA and IA-2A in 135 patients with T1DM were 35.6% (48/135), 57.0% (77/135) and 23.7% (32/135), respectively. The combined detection of three antibodies The positive rate was 70.4% (95/135). The titer of ZnT8A and IA-2A decreased by 42.2% and 44.8% respectively in the 15th and 18th months after the onset of disease, with a significant change (P <0.001), but no significant decrease afterwards (P> 0.05) ; GADA showed no significant change (P> 0.05). The levels of ZnT8A and IA-2A were decreased by 48.2% and 54.1% in 75 patients with T1DM from 5 to 10 years, respectively, with significant changes (P <0.001) and no significant changes in GADA (P> 0.05). Conclusions The levels of ZnT8A and IA-2A are significantly decreased with the prolongation of the course of disease in the early stage of T1DM, especially within 18 months after onset, while GADA does not change with the course of disease.