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目的:探讨锌转运体8自身抗体(zinc transporter 8 antibody,ZnT8A)在江苏地区1型糖尿病(type 1 diabetes mellitus,T1DM)诊断中的价值及ZnT8A与人类白细胞抗原(HLA)-A基因的关系。方法:横断面、病例对照研究,T1DM和正常对照组均采用免疫配体法检测胰岛自身抗体:谷氨酸脱羧酶抗体(GADA)、蛋白酪氨酸磷酸酶抗体(IA-2A)、胰岛素自身抗体(IAA)和ZnT8A,PCR-SSO方法进行HLA-A的分型。结果:(1)140例TIDM患者中65例ZnT8A阳性(阳性率46.4%),102例正常对照组中仅1例ZnT8A阳性(阳性率1.0%),差异有统计学意义(P<0.05);(2)联合检测GADA、IAA、IA-2A 3个传统抗体,至少1个抗体阳性率为70.7%(99/140);联合检测GADA、IAA、IA-2A和ZnT8A 4个抗体,至少1个抗体阳性率为86.4%(121/140)(P<0.05),ZnT8A在其他3个抗体阴性的患者中仍有15.7%的阳性率;(3)HLA-A*24在T1DM组较正常对照组明显升高(P<0.05,OR=1.654),A*33与正常对照组相比明显下降(P<0.05,OR=0.161);(4)HLA-A*02在ZnT8A阳性组明显高于ZnT8A阴性组(P<0.05,OR=0.318),在校正病程、发病年龄、体重指数(BMI)等可能影响因素后,差异无统计学意义。结论:ZnT8A使T1DM患者自身抗体阳性率提高了15.7%,有助于提高T1DM的诊断;暂未发现HLA-A与ZnT8A的相关性。
Objective: To investigate the value of zinc transporter 8 antibody (ZnT8A) in the diagnosis of type 1 diabetes mellitus (T1DM) and the relationship between ZnT8A and human leukocyte antigen (HLA) -A in Jiangsu Province. Methods: Cross-sectional and case-control study, T1DM and normal control group were detected by immuno-ligand method of islet autoantibodies: GAD, IA-2A, Antibody (IAA) and ZnT8A, PCR-SSO method of HLA-A typing. Results: (1) The positive rate of ZnT8A in 65 TIDM patients was 46.4% (positive rate was 46.4%), and only 1 of 102 normal controls was positive for ZnT8A (positive rate was 1.0%). The difference was statistically significant (P <0.05). (2) The combined detection of GADA, IAA, IA-2A three traditional antibodies, at least one antibody positive rate was 70.7% (99/140); combined detection of GADA, IAA, IA-2A and ZnT8A four antibodies, at least one The positive rate of antibody was 86.4% (121/140) (P <0.05), and the positive rate of ZnT8A was 15.7% in the other three antibody negative patients. (3) The positive rate of HLA-A * 24 in T1DM group was higher than that in the normal control group (P <0.05, OR = 1.654), A * 33 decreased significantly compared with the normal control group (P <0.05, OR = 0.161); (4) The expression of HLA-A * 02 in ZnT8A positive group was significantly higher than that of ZnT8A Negative group (P <0.05, OR = 0.318). There was no significant difference after adjusting for possible course of disease, age of onset, body mass index (BMI) and other possible influencing factors. Conclusion: The positive rate of autoantibodies in patients with T1DM increased by 15.7% with ZnT8A, which is helpful to improve the diagnosis of T1DM. No correlation was found between HLA-A and ZnT8A yet.