【摘要】 目的探讨成人隐匿性自身免疫性糖尿病(LADA)患者病情随病程进展的变化情况。方法从300例2型糖尿病患者中筛选出LADA28例,进行5年前后的临床、胰岛功能及免疫学比较研究。结果28例LADA患者5年后病情加重,胰岛功能减退直至衰竭,谷氨酸脱羧酶抗体(GAD-Ab)持续阳性的患者β细胞功能呈进行性减退。结论LADA患者随病程延长其胰岛β细胞功能呈进行性减退直至衰竭而必须依赖胰岛素治疗;GAD-Ab持续阳性的患者β细胞功能呈进行性减退。更多还原

【Abstract】 Objective To investigate the LADA variations in clinical,β cell function and immunologic characteristics with advancement of the course of disease.Methods We examined GAD-Ab in 300 patients with type 2 diabetes among whom,28 cases showed the positive GAD-Ab,and were diagnosed as LADA and followed up for 5 years.Results The LADA patients had similar clinical manifestations to those of type 2 diabetes,and treatments with diet and oral hypoglycemic agents were effective in initial stage.After 5 years,they showed severe symptoms.The mean levels of fasting and 1h postprandial C-peptide were reduced(all P<0.05).GAD-Ab of 12 patients kept positive.The C-peptide value of other 16 patients,whose GAD-Ab conversed negative,kept no variation(P>0.05).Conclusion The clinical manifestations of LADA may be similar to those of type 2 diabetes with oral hypoglycemic agents being effective in initial stage.Over the course of disease,the β-cell function attenuates progressively even to failure.It is necessary to treat LADA patients with insulin early.更多还原