【摘要】 目的　探讨羧基肽酶 H自身抗体 (CPH Ab)阳性的 2型糖尿病 (T2DM)患者的临床特征及该抗体对成人隐匿性自身免疫糖尿病 (LADA)的诊断价值。　方法　选择临床初诊为T2DM患者 5 4 5例 ,1型糖尿病 (T1DM)患者 85例 ,健康对照 12 3例进行CPH Ab测定 ,同时检测T2DM患者谷氨酸脱羧酶抗体 (GAD Ab)。比较各组CPH Ab的阳性率以及T2DM中依据CPH Ab、GAD Ab划分的 3组患者的临床特点。采用放射免疫沉淀法检测CPH Ab和GAD Ab。　结果　CPH Ab阳性率在T2DM患者 ( 5 .5 % ,30 /5 4 5 )高于T1DM患者 ( 0 % ,0 / 85 )和正常对照 ( 0 .8% ,1/ 12 3) (P <0 .0 5 ) ,30例CPH Ab阳性的T2DM患者只有 1例同时GAD Ab阳性。CPH Ab在低体重 (BMI<2 1kg/m2 )者中的阳性率较高 ,且该抗体阳性的患者具有起病年龄跨度大、病程较长、低体重、易发生酮症等特点 ,其空腹C肽介于GAD Ab阳性与两种抗体(GAD Ab和CPH Ab)均阴性的T2DM患者之间 ,反映代谢综合征的指标水平较低 (包括较低的BMI、血压和甘油三酯 ) ,而周围神经病变的比例较高。　结论　CPH Ab阳性糖尿病患者的临床特点介于经典的LADA(GAD Ab阳性 )与T2DM患者间。CPH抗体检测是LADA诊断的一项新指标更多还原

【Abstract】 Objective To explore the clinical characteristics of type 2 diabetic patients with carboxypeptidase H antibody (CPH Ab) and to disclose the value of CPH Ab in the diagnosis of latent autoimmune diabetes in adults (LADA). Methods We screened 545 patients with initially diagnosed type 2 diabetes mellitus (T2DM), 85 type 1 diabetic (T1DM) patients and 123 healthy controls for CPH Ab assay, and also GAD Ab assay for the T2DM group. T2DM patients were divided into 3 groups according to CPH Ab and GAD Ab to compare the clinical characteristics of them. CPH Ab and GAD Ab were detected with RIA. Results The prevalence of CPH Ab in T2DM (5.5% ,30/545) was higher than that of T1DM patients(0%,0/85; P <0.05) and healthy controls (0.8%, 1/123; P< 0.05). Only 1 was GAD Ab positive in 30 type 2 diabetics with positive CPH Ab. The positivity of CPH Ab was more higher in patients with lower body weight (BMI<21 kg/m 2), and the patients with CPH Ab had a wider range of age at onset, longer duration of disease, lower body mass index and more tendency to develop ketosis. Their fasting C peptide level was between those of the patients with GAD Ab and the patients without any antibody (GAD Ab and CPH Ab), and these patients had less metabolic syndrome (including lower levels of BMI, hypertension percentage and serum triglyceride) and more peripheral neuropathy. Conclusion The clinical characteristics of patients with CPH Ab are between that of classical LADA who is GAD Ab positive and T2DM patients. CPH Ab was a new autoimmune marker for the diagnosis of LADA.更多还原