南方医科大学学报

南方医科大学学报 ›› 2006, Vol. 26 ›› Issue (07): 1034-1036.

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血清胰岛自身抗体在肝源性糖尿病诊断中的价值

张玲； 石亚玲； 洪文昕； 贾卫东； 李凌华；   

  1. 广州市第八人民医院； 广州市第八人民医院 广东广州510060； 广东广州510060；
  • 出版日期:2006-07-20 发布日期:2006-07-20

Diagnostic value of serum islet autoantibody in hepatogenic diabetes mellitus

ZHANG Ling, SHI Ya-ling, HONG Wen-xing, JIA Wei-dong, LI Ling-hua Eighth People’s Hospital of Guangzhou, Guangzhou 510060, China   

  1. 广州市第八人民医院； 广州市第八人民医院 广东广州510060； 广东广州510060；
  • Online:2006-07-20 Published:2006-07-20

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摘要： 目的探讨血清胰岛自身抗体一谷氨酸脱羧酶抗体(GADA)和胰岛细胞抗体(ICA)在肝源性糖尿病诊断中的价值。方法采用酶联免疫吸附实验测定217例慢性乙型肝炎(CH)、肝硬化(LC)患者血清GADA和ICA,观察GADA、ICA在CH、LC阶段的阳性率及其与糖尿病的关系。结果CH、LC合并糖尿病的患者72%(56/77)循环中存在一种胰岛自身抗体,而血糖正常的CH、LC患者胰岛自身抗体的阳性率为30%(42/140),两组比较差异有显著性(χ2=36.620,P=0.000)。CH合并糖尿病患者胰岛自身抗体阳性率52%(13/25)明显高于2型糖尿病(NIDDM)合并肝损害的患者8%(2/25)(P<0.05)。C肽水平下降的CH、LC患者中胰岛自身抗体阳性率70%(24/34)亦明显高与C肽水平正常的患者40%(74/183)(P<0.05)。结论GADA、ICA在肝源性糖尿病的诊断中有重要参考价值,可作为肝源性糖尿病和2型糖尿病的实验室鉴别诊断指标。 

Abstract: Objective To investigate the diagnostic value of serum islet autoantibody-glutamic acid decarboxylase antibody (GADA) and islet cell antibody (ICA) in patients with hepatogenic diabetes. Methods Serum GADA and ICA were measured with enzyme-linked immunosorbent assay (ELISA) in 217 patients with chronic hepatitis B (CH) or liver cirrhosis (LC). The positivity rate of GADA and ICA in different phases of CH and LC and their relations with diabetes mellitus were analyzed. Results The positivity rate of the islet autoantibody in the circulation was 72% (56/77) in CH and LC patients with diabetes mellitus and 30% (42/140) in patients with normal glucose level, showing significant difference between the two patient groups (χ2=36.620, P=0.000). CH patients with diabetes had much higher positivity rate for the antibody [52% (13/25) than type 2 diabetic patients with liver dysfunction [8% (2/25), P<0.05]. The positivity rate was also much higher in CH and LC patients with lowered C peptide level [70% (24/34)] than in those with normal C peptide level [40% (74/183), P<0.005]. Conclusion Both GADA and ICA have important value in the diagnosis of hepatogenic diabetes and may serve as indexed in laboratory test for distinguishing hepatogenic diabetes from type 2 diabetes. 

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