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目的通过谷氨酸脱羧酶抗体 (GAD Ab)测定 ,了解成人迟发性自身免疫性糖尿病 (LA DA)在Ⅱ型糖尿病中的发病率 ,以及LADA的一些临床特点。方法对 91例诊断为Ⅱ型糖尿病患者及2 8例正常对照组用ELISA法检测血清中GAD Ab。结果GAD Ab阳性率 17 5 8% ,高于对照组的 0 % ;且GAD Ab阳性患者具有低体重指数 (BMI)≤ 2 1kg m2 ,低C肽分泌 ,酮症史 ,胰岛素用量偏大的临床特点 ;而起病年龄、病程及男女比例与阴性无显著差异。结论LADA在Ⅱ型糖尿病中比例较高 ;Ⅱ型糖尿病中低BMI,低C肽分泌 ,酮症史 ,胰岛素用量偏大是LADA诊断的重要线索 ;GAD Ab检测对早期诊断LADA有实验价值。
Objective To investigate the incidence of type 2 diabetes mellitus (T2DM) in adults with delayed autoimmune diabetes (LA DA) and the clinical features of LADA by measuring glutamate decarboxylase antibody (GAD Ab). Methods Serum GAD Ab was detected by ELISA in 91 patients diagnosed as type Ⅱ diabetes mellitus and 28 normal controls. Results The positive rate of GAD Ab was 17 58%, which was higher than 0% of the control group. The patients with positive GAD Ab had low BMI ≤ 21 kg m2, low C-peptide secretion, history of ketosis and high insulin dosage Characteristics; but the onset age, duration and the male-female ratio and negative no significant difference. Conclusions LADA has a high proportion of type 2 diabetes mellitus. Type 2 diabetes mellitus has low BMI, low C-peptide secretion, history of ketosis and high insulin dosage, which are important clues for the diagnosis of LADA. The detection of GAD Ab is of value in the early diagnosis of LADA.