ICA、ZnT8A、GADA联合检测对重庆儿童1型糖尿病早期诊断的意义

发布时间：2018-02-25 05:19

本文关键词： 型糖尿病胰岛细胞抗体锌转运体自身抗体谷氨酸脱羧酶抗体自身抗体联合检测　出处：《重庆医科大学学报》2017年05期 　论文类型：期刊论文

【摘要】：目的:通过观察研究重庆地区1型糖尿病(type 1 diabetes mellitus,T1DM)儿童患者血清中胰岛细胞抗体(islet cell antibodies,ICA)、锌转运体8自身抗体(zinc transporter isoform 8 autoantibodies,Zn T8A)和胰岛相关自身抗体谷氨酸脱羧酶抗体(glutamic acid decarboxylase antibodies,GADA)的阳性率及其空腹C肽结果,探讨ICA、Zn T8A和GADA联合检测对1型糖尿病早期诊断的价值。方法:在我院初诊的T1DM组139例和正常组78例儿童,采用酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA)检测ICA、Zn T8A和GADA;放射免疫法测定空腹C肽。T1DM组按自身抗体结果分为阳性组和阴性组。结果:1型糖尿病组的血清ICA、Zn T8A和GADA阳性率分别为61.9%(P=0.000)、51.1%(P=0.000)和54.0%(P=0.000),均明显高于正常对照组;抗体联合检测组的诊断符合率(ICA/Zn T8A=80.6%;ICA/GADA=81.6%;Zn T8A/GADA=78.3%;ICA/Zn T8A/GADA=88.9%)均高于单项抗体检测组,抗体联合检测与任一抗体单项检测的ROC曲线下面积相比均明显增大(P0.05),3种抗体联合检测AUC=0.883(95%CI=0.830~0.936,P=0.000);抗体阳性患者的空腹C肽水平明显低于抗体阴性患者。结论:ICA、Zn T8A和GADA三者联合检测可以明显提高1型糖尿病的诊断效能。
[Abstract]:Objective: to study the islet cell antibodies-ICAX, zinc transporter 8 autoantibody transporter isoform 8 autoantibodies-Zn T8A and islet associated autoantibodies glutamate decarboxylase in children with type 1 diabetes mellitus type 1 diabetes mellitusus T1DMm in Chongqing area. The positive rate of glutamic acid decarboxylase antibodies-GADAs and the results of fasting C-peptide, To explore the value of combined detection of GADA and T8A in the early diagnosis of type 1 diabetes mellitus methods: 139 cases of T1DM group and 78 cases of normal group were enrolled in our hospital. Enzyme linked immunosorbent Assay Elisa was used to detect ICAZn-T8A and GADA.The radioimmunoassay was used to detect fasting C-peptide. T1DM group was divided into positive group and negative group according to the results of autoantibody. Results the positive rates of serum ICAAn Zn T8A and GADA in type 1 diabetes mellitus group were 61.9% and 51.1T = 0.000, respectively. Compared with the normal control group, the content of PX 0.000 and 54.0% were significantly higher than that of the normal control group. The diagnostic coincidence rate of the combined antibody detection group and the ICA / Zn T8A / GADAA 80.6 group was higher than that of the single antibody detection group, and the ICA / Zn T8A / GADAA 81.6 and Zn T8A / GADAA 78.3% ICA / Zn T8A / GADAA / 88. 9% ICA / Zn T8A / GADAA 80.6were higher than those of the single antibody test group. The area under ROC curve of antibody combined detection was significantly larger than that under ROC curve of any single antibody detection. Conclusion\\\;\\; Combined detection can significantly improve the diagnostic efficacy of type 1 diabetes.
【作者单位】：重庆医科大学附属儿童医院检验科;重庆医科大学检验医学院教育部临床检验诊断学重点实验室;
【基金】：国家自然科学基金面上资助项目(编号:81570752) 重庆市卫计委资助项目(编号:渝卫科教2013-2-048)
【分类号】：R446.1;R725.8

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