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目的:比较1型糖尿病(type 1 diasetes,T1D)胰岛自身抗体阳性率与年龄和病程之间的关系。方法 :对537例T1D患者检测其胰岛自身抗体,并收集一般信息和实验室检查结果,再将患者按年龄和病程进行分组,比较不同年龄和病程组患者胰岛自身抗体阳性率的差异。结果:537例患者平均年龄为(32.84±17.98)岁,平均病程为4.31年。谷氨酸脱羧酶抗体(GADA)、蛋白酪氨酸磷酸酶抗体(IA-2A)、锌转运体8自身抗体(Zn T8A)和胰岛细胞抗体(ICA)的阳性率分别为54.4%、30.8%、28.2%和23.5%,至少1个抗体阳性率为75.4%。青春期前后的患者抗体阳性率分别为GADA 76.9%vs 57.4%(P=0.039),IA-2A 65.4%vs31.7%(P=0.001),Zn T8A 38.5%vs 24.1%(P=0.108),至少1个抗体阳性83.3%vs 75.7%(P=0.014)。病程5年以内至少1个抗体阳性率为55.7%,而5年以上的阳性率为44.1%(P=0.032)。结论:随着T1D患者病程延长,抗体阳性率逐渐降低;患者年龄越小,抗体阳性率越高。因此对于成人T1D的诊断要应该更仔细,避免漏诊。
Objective: To compare the positive rate of type 1 diasetes (T1D) islet autoantibodies with age and duration of disease. Methods: 537 patients with T1D were tested for their autoantibodies against pancreatic islets, and the general information and laboratory findings were collected. The patients were divided into groups according to their age and course of disease. The differences of the positive rates of autoantibodies to islets among different age and duration groups were compared. Results: The average age of 537 patients was (32.84 ± 17.98) years, the average duration was 4.31 years. The positive rates of GADA, IA-2A, Zn T8A and ICA were 54.4%, 30.8% , 28.2% and 23.5%, respectively. The positive rate of at least one antibody was 75.4%. The positive rates of patients before and after puberty were GADA 76.9% vs 57.4% (P = 0.039), IA-2A 65.4% vs 31.7% (P = 0.001), Zn T8A 38.5% vs 24.1% (P = 0.108) One antibody was positive 83.3% vs 75.7% (P = 0.014). The positive rate of at least one antibody was 55.7% within 5 years and 44.1% over 5 years (P = 0.032). CONCLUSION: With the prolongation of T1D, the positive rate of antibody gradually decreases. The younger the patient, the higher the positive rate of antibody. Therefore, the diagnosis of adult T1D should be more careful to avoid missed diagnosis.