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目的 :探讨羧基肽酶H(carboxypeptidaseH ,CPH)自身抗体检测对成人隐匿性自身免疫性糖尿病 (LA DA)的诊断价值。方法 :选择 1型糖尿病患者 15 4例 ,2型糖尿病患者 10 4例 ,健康对照 14 4例。重组人CPH在体外翻译时用3 5S 甲硫氨酸标记 ,采用免疫沉淀法检测血清CPH抗体滴度。谷氨酸脱羧酶抗体 (GAD Ab)、酪氨酸磷酸酶细胞内段抗体 (IA2ic Ab)和胰岛素自身抗体 (IAA)均采用放射免疫分析法检测。结果 :CPH抗体频率在 1型糖尿病患者 (5 / 15 4 ,3.2 % ) ,2型糖尿病患者 (6 / 10 4 ,5 .7% )和健康对照 (3/ 14 4 ,2 .1% )间差异无显著性 (P >0 .0 5 )。 2型糖尿病患者GAD Ab ,IA2ic Ab和IAA频率分别为 15 .4 % (16 / 10 4 ) ,2 .9% (3/ 10 4 )和 2 .3% (1/ 4 3) ,且IA2ic Ab或IAA阳性者均为GAD Ab阳性 ,但CPH抗体阳性者无一例GAD Ab ,IA2ic Ab和IAA阳性。结论 :CPH抗体对LADA有辅助诊断价值 ,与GAD Ab联合检测可提高LADA诊断的敏感性。
Objective: To investigate the diagnostic value of carboxypeptidase H (CPH) autoantibodies in the diagnosis of adult latent autoimmune diabetes (LA DA). Methods: A total of 154 patients with type 1 diabetes, 104 patients with type 2 diabetes and 14 4 healthy controls were selected. Recombinant human CPH was labeled with 3 5S methionine in vitro and serum CPH antibody titer was detected by immunoprecipitation. GAD Ab, IA2ic Ab and IAA were detected by radioimmunoassay. Results: The frequency of CPH antibody was significantly higher in patients with type 1 diabetes (5/154, 3.2%), patients with type 2 diabetes (6/104, 57%) and healthy controls (3/14 4, 2.1%) There was no significant difference (P> 0.05). The frequencies of GAD Ab, IA2ic Ab and IAA in type 2 diabetic patients were 15.4% (16/104), 2.9% (3/10 4) and 2.3% (1/4 3), respectively, and IA2ic Ab Or IAA positive were all GAD Ab positive, but none of CPH antibody positive cases were GAD Ab, IA2ic Ab and IAA positive. Conclusion: CPH antibody has diagnostic value for LADA, and combined with GAD Ab can improve the diagnostic sensitivity of LADA.