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为探讨成人晚发自身免疫性糖尿病 (L ADA)的临床及代谢特征 ,为临床早期发现本病提供依据 ,以胰岛细胞自身抗体 (ICA)阳性为 L ADA主要诊断依据 ,将其临床表现与速发型 1型糖尿病 (DM1)、2型糖尿病(DM2 )进行比较。结果显示 ,L ADA的临床特征为 :1发病年龄 >2 5岁 ,多在 45岁左右 ;2胰岛 β细胞功能比正常人低下 ,但明显高于 DM1,C肽释放曲线与 DM2患者相似 ,但绝对值较低 ;3具有与 DM1相似的免疫学特征 ,ICA阳性 ;4酮症出现时间明显迟于 DM1患者 ,多数患者发病 1.5年之内无酮症。提示 L ADA为免疫介导的自身免疫性疾病 ,其本质为胰岛素β细胞的免疫性损伤 ,根据上述特征可早期发现本病。
In order to explore the clinical and metabolic characteristics of late onset autoimmune diabetes (L ADA) in adults, this study provides a basis for the early detection of this disease in clinical practice. Based on the primary diagnosis of islet cell autoantibodies (ICA) positive for L ADA, Hair type 1 diabetes mellitus (DM1), type 2 diabetes mellitus (DM2). The results showed that the clinical features of LADA were as follows: 1 The age of onset> 25 years old, mostly around 45 years old; 2 The function of 2 islet β cells was lower than that of normal people, but significantly higher than that of DM1. Absolute low value; 3 with similar immunological characteristics of DM1, ICA positive; 4 ketosis was significantly later than DM1 patients, the majority of patients within 1.5 years of onset of ketosis. Tip L ADA is an immune-mediated autoimmune disease, its essence is the immune damage of insulin beta cells, according to the above characteristics can be early detection of the disease.