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目的 评价血清谷氨酸脱羧酶抗体 (GAD- Ab)、胰岛细胞抗体 (ICA)和胰岛素自身抗体 (IAA)联合测定对成人隐匿性自身免疫性糖尿病 (L ADA)的诊断价值。方法 利用 EL ISA法测定 1 38例临床诊断为 2型糖尿病患者及 4 6例健康者的血清 GAD- Ab、 ICA和 IAA,并比较抗体阳性和阴性患者的临床特征。结果 临床诊断为2型糖尿病患者 GAD- Ab和 ICA的阳性率分别为 2 0 .3%和 1 1 .6 % ,与对照组比较差异有显著性 (X2 =8.5 2 8,P=0 .0 0 3;X2 =5 .84 1 ,P=0 .0 1 6 ) ;IAA的阳性率 8.0 % ,与对照组比较无显著性差异 (X2 =1 .90 2 ,P=0 .1 6 8)。抗体阳性患者血清 C肽水平较低。结论 胰岛自身抗体联合检测可提高 L ADA患者的检出率 ;L ADA患者胰岛储备功能较差
Objective To evaluate the diagnostic value of serum glutamic acid decarboxylase antibody (GAD-Ab), islet cell antibody (ICA) and insulin autoantibodies (IAA) in the diagnosis of latent occlusive autoimmune diabetes (LADA) in adults. Methods The serum levels of GAD-Ab, ICA and IAA were measured in 138 patients with type 2 diabetes mellitus and 46 healthy controls by ELISA. The clinical features of patients with positive and negative antibodies were compared. Results The positive rates of GAD-Ab and ICA in patients with type 2 diabetes mellitus were 20.3% and 11.6% respectively, which were significantly different from those in control group (X2 = 8.528, P = 0.0 The positive rate of IAA was 8.0%, which showed no significant difference compared with the control group (X2 = 1.902, P = 0.186) . Antibody-positive patients with lower serum C-peptide levels. Conclusion Combined detection of islet autoantibodies can improve the detection rate of L ADA patients; L ADA patients with poor islet storage function