锌转运体8自身抗体对1型糖尿病诊断价值及其与HLA-A基因的关系

发布时间：2018-02-03 05:33

本文关键词： 型糖尿病锌转运体自身抗体人类白细胞抗原　出处：《南京医科大学学报(自然科学版)》2017年10期 　论文类型：期刊论文

【摘要】：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(P0.05);(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)(P0.05),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(P0.05,OR=1.654),A*33与正常对照组相比明显下降(P0.05,OR=0.161);(4)HLA-A*02在ZnT8A阳性组明显高于ZnT8A阴性组(P0.05,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。
[Abstract]:Objective: to investigate the zinc transporter 8 transporter 8 antibody. Type 1 diabetes mellitus of type 1 diabetes mellitus in Jiangsu province. The diagnostic value of T1DMand the relationship between ZnT8A and HLA-A gene of human leukocyte antigen. Methods: Cross-sectional, case-control study. The islet autoantibodies were detected by immunoligand method: glutamate decarboxylase antibody (GADAA), protein tyrosine phosphatase antibody (IA-2A). Insulin autoantibodies (IAA) and ZnT8A. Results 65 of 140 patients with TIDM were ZnT8A positive (46.4%). Only 1 case (positive rate 1.0%) of ZnT8A was positive in 102 cases of normal control group. The difference was statistically significant (P 0.05). (2) the positive rate of at least one antibody was 70.7 / 140U when the three traditional antibodies of GADAA IAA IA-2A were detected. The positive rate of at least one antibody was 86.4% (P 0.05). ZnT8A still had a positive rate of 15.7% among the other 3 antibody negative patients. In the T1DM group, the level of P0.05 OR1. 654 AnAN33 in the T1DM group was significantly higher than that in the normal control group (P 0. 05, P 0. 05, P 0. 05, P 0. 05, P < 0. 05). ORX 0.161; In ZnT8A positive group, it was significantly higher than that in ZnT8A negative group (P 0.05), and in correcting the course of disease and the age of onset. There was no significant difference in body mass index (BMI) and other possible influencing factors. Conclusion the positive rate of autoantibodies in T1DM patients was increased by 15.7%% ZnT8A. It is helpful to improve the diagnosis of T1DM. No correlation between HLA-A and ZnT8A was found.
【作者单位】：江苏大学附属人民医院内分泌科;南京医科大学第一附属医院内分泌科;
【基金】：镇江市社会发展科技支撑项目(SH2013052)
【分类号】：R587.1
【正文快照】： 1型糖尿病(type 1 diabetes mellitus,T1DM)是遗传易感个体在环境因素触发下,由致病性T细胞介导的,以胰岛β细胞自身免疫性破坏为特征的器官特异性自身免疫性疾病。多种基因与T1DM的遗传易感性相关,如人类白细胞抗原(HLA)基因、胰岛素(INS)基因、细胞毒性T淋巴细胞相关蛋白4(C

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