【摘要】 目的　应用ICA5 12 /IA 2抗体与谷氨酸脱羧酶 (GAD)抗体联合筛查中国人糖尿病患者中的自身免疫中介 1型糖尿病。方法　 487例中国人 ,按原WHO 1985标准诊断为非糖尿病 10 9例、IDDM 35例及NID DM 34 3例。对象血清ICA5 12 /IA 2抗体及GAD抗体的检测采用放射配体法 ,以人重组ICA5 12 /IA 2及GAD6 5为抗原 (英国RSR公司 )。结果　 (1)非糖尿病、IDDM组及NIDDM组ICA5 12 /IA 2抗体阳性率分别为0 .9%、14.3%及 2 .3% (IDDM组比非糖尿病组及NIDDM组P均 <0 .0 0 1) ,GAD抗体阳性率分别为 0 .9%、40 .0 %及 10 .2 % (IDDM组比非糖尿病组及NIDDM组P均 <0 .0 0 1,NIDDM组与非糖尿病组P <0 .0 1)。 (2 )非糖尿病、IDDM组及NIDDM组ICA5 12 /IA 2及 /或GAD抗体阳性率分别为 1.8%、42 .9%及 11.7% (IDDM组比非糖尿病组及NIDDM组P均 <0 .0 0 1,NIDDM组比非糖尿病组P <0 .0 1)。 (3)NIDDM组中的自身抗体阳性者年龄、诊断年龄及病程均小于阴性组 (P <0 .0 5 ) ,应用胰岛素者显著多于阴性组 (P <0 .0 5 )。 75 %阳性者BMI<2 5。 (4)NIDDM组中抗体阳性者在病程≤ 1年、～ 5年及 >5年者中分别占 5 2 .0 %、30 .0 %及 17.5 % (P <0 .0 5 )。结论　在中国人临床表现为NIDDM患者中 ,至少有 12 .0 %为自身免疫中介 1型糖尿病。更多还原

【Abstract】 Objective In this paper, the combined detection of ICA512/IA 2 antibody and glutamic acid decarboxylase (GAD) antibody for screening autoimmune mediated type 1 diabetes was performed in Chinese.Methods The study population consisted of 487 Chinese individuals. According to the WHO 1985 diagnostic criteria, 109 were non diabetic subjects, 35 were IDDM and 343 were NIDDM. Serum ICA512/IA 2 antibody and GAD antibody were detected by radioligand assay. The antigens for these assays were recombinant human ICA512/IA 2 and GAD antigens (RSR Ltd. U.K.). Results (1) The percentages of positive ICA512/IA 2 antibody detected in non diabetic, IDDM and NIDDM groups were 0.9%,14.3% and 2.3% respectively (IDDM vs. non diabetics and NIDDM, P both <0.001); the percentages of positive GAD antibody in these groups were 0.9%, 40.0% and 10.2%, respectively (IDDM vs. non diabetics and NIDDM; P both <0.001, NIDDM vs. non diabetics, P <0.01). (2) The percentages of positive ICA512/IA 2 and /or GAD antibodies in non diabetics, IDDM and NIDDM groups were 1.8%, 42.9% and 11.7%, respectively (IDDM vs. non diabetics and NIDDM, P both <0.001; NIDDM vs. non diabetics, P <0.01). (3) NIDDM group with positive autoantibody was younger, also at a younger age when diagnosed with shoedten course and required insulin therapy more often than NIDDM without autoantibody ( P <0.05). 75% of NIDDM subjects with positive autoantibodies had BMI <25.0. (4) The percentages of duration of onset =<1 yr, 5yrs and >5yrs in NIDDM group subjects with autoantibodies were 52.0%, 30.0% and 17.5%, respectively.Conclusion At least 12% of the Chinese subjects manifested clinically as NIDDM were subjects with type 1 autoimmune mediated diabetes.更多还原