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目的:探讨急性起病的1型糖尿病(T1DM)患者血清谷氨酸脱羧酶抗体(GADA)、胰岛细胞抗体(ICA)、胰岛素自身抗体(IAA)与HLA-A等位基因之间的关系。方法:采用酶联免疫吸附法(ELISA)定性检测104例江苏地区汉族T1DM患者与110例正常对照的GADA、ICA和IAA。从外周血中提取细胞基因组DNA,运用聚合酶链反应-寡核苷酸探针序列特异性引物(PCR-SSO)技术,检测T1DM患者和正常对照的HLA-A基因频率。应用SPSS11.0软件进行T1DM发病年龄及自身抗体与HLA-A基因频率的相关性分析。结果:T1DM组与正常对照组相比,A*03、A*24频率明显升高,A*01、A*11、A*31频率明显下降。起病年龄20岁以下的急性起病T1DM患者与20岁以上患者比较,携带HLA-A*24基因型频率增高,而HLA-A*31等位基因频率减少。携带HLA-A*03等位基因的急性起病T1DM患者GADA、ICA阳性率高于不携带A*03者;携带HLA-A*24等位基因的急性起病T1DM者ICA阳性率高于不携带A*24者。结论:本研究发现在江苏地区急性起病的T1DM患者中,A*03、A*24是易感基因,而A*01、A*11、A*31是保护性基因,A*31可能延缓1型糖尿病的发病;A*31与发病年龄正相关,ICA、A*24与发病年龄负相关;A*03、A*24与GADA正相关,A*24与ICA正相关。
Objective: To investigate the relationship between serum glutamic acid decarboxylase antibody (GADA), islet cell antibody (ICA), insulin autoantibodies (IAA) and HLA-A alleles in patients with acute onset type 1 diabetes mellitus (T1DM). Methods: GADA, ICA and IAA in 104 Chinese Han patients with T1DM and 110 normal controls were detected by enzyme linked immunosorbent assay (ELISA). Genomic DNA was extracted from peripheral blood and the frequency of HLA-A gene in T1DM patients and normal controls was detected by polymerase chain reaction-oligonucleotide probe sequence specific primers (PCR-SSO). SPSS11.0 software was used to analyze the correlation between T1DM onset age, autoantibodies and HLA-A gene frequency. Results: Compared with the normal control group, the frequencies of A * 03 and A * 24 in T1DM group were significantly increased and the frequencies of A * 01, A * 11 and A * 31 decreased significantly. The frequency of HLA-A * 24 genotypes was increased and the frequency of HLA-A * 31 alleles was decreased in patients with acute onset of T1DM who were less than 20 years of age at onset compared with those over 20 years of age. The positive rate of GADA and ICA in T1DM patients with acute onset HLA-A * 03 allele was higher than those without A * 03, and the positive rate of ICA in T1DM patients with HLA-A * 24 allele was higher than that without A * 03 Carry A * 24 who. Conclusion: This study found that A * 03 and A * 24 are susceptible genes in T1DM patients with acute onset in Jiangsu Province, whereas A * 01, A * 11 and A * 31 are protective genes and A * 31 may be delayed A * 31 was positively correlated with age of onset, ICA, A * 24 was negatively correlated with age of onset; A * 03, A * 24 was positively correlated with GADA, while A * 24 was positively correlated with ICA.