1型儿童和青少年的IAA、GAD65和IA2抗体

Dr Yasir Naqi Khan, Dr Muhammad Ashfaq, Dr Bader-u-Nisa, Dr Mehrunnisa Yasir, Dr Hira Waseem, M. A. Kanpurwala
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摘要

目的:糖尿病(DM)是一种复杂的、长期的代谢紊乱,可导致高血糖,是由于胰岛素完全缺乏和胰岛素抵抗而发生的。儿童和青少年中最常见的糖尿病是1型糖尿病(T1DM)。本研究的目的是确定1型糖尿病患者IAA、GAD65和IA-2A抗体与年龄、性别和病程的关系。方法:本研究采用非概率连续抽样技术,经伦理批准,在NICH医院内分泌与糖尿病科进行回顾性研究。研究的持续时间为一年。本研究共选取143例临床诊断为1型糖尿病的患者(年龄在1岁至20岁之间,不论病程长短)。对所有研究对象进行胰腺自身免疫标志物(GAD65、IA-2A、IAAs)检测。采用皮尔逊卡方检验评价相关性。结果:共有143名诊断为1型糖尿病的儿童入组,其中71名(49.7%)为男性,72名(50.3%)为女性。自身抗体阳性分布中,抗胰岛素IgG 27例(18.9%),GAD65 63例(44.1%),IA-2A 47例(32.9%),灰色地带5例(3.5%)。据报道,糖尿病病程与IAA有显著相关性(p<0.001)。此外,糖尿病病程与IA-2A发作频率有统计学意义(p=0.003)。结论:胰岛素瘤相关抗原-2自身抗体、胰岛素自身抗体和谷氨酸脱羧酶65等自身抗体的存在在男性中高于女性,但与年龄和性别无显著相关性。此外,存在胰岛素瘤相关抗原-2自身抗体,胰岛素自身抗体与疾病持续时间显著相关。
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IAA, GAD65 AND IA2 Antibodies In Type 1 Children and Adolescents
Objective: Diabetes mellitus (DM) is a complicated, prolonged metabolic disorder that leads to hyperglycemia and it occurrs due to complete deficiency of insulin with or with insulin resistance. The most common type of DM in children and adolescents is Type-1 DM (T1DM). The aim of this study was to determine the associations of IAA, GAD65 and IA-2A antibodies in type 1 diabetes mellitus with age, gender and duration of disease. Methodology: This was a retrospective study conducted in the NICH hospital at the department of endocrinology and diabetes by using non probability consecutive sampling technique, after taking ethical approval. The duration of the study was one year. A total of 143 patients with clinically diagnosed type 1 diabetes ( ?1 year to ?20 years of age, regardless of the duration of the disease) were selected for the study. All study subjects were investigated for pancreatic autoimmune markers (GAD65, IA-2A, IAAs). Pearson’s Chi square test was applied to evaluate the association. Results: A total of 143 children diagnosed with type 1 diabetes were enrolled for this study wherein 71(49.7%) were males and 72(50.3%) were females. Regarding the distribution of positivity of autoantibodies, 27(18.9%) had AntiInsulin IgG, 63(44.1%) had GAD65, 47(32.9%) had IA-2A and only 5(3.5%) had grey zone. There was a significant association was reported (p<0.001) in duration of diabetes and with IAA. Furthermore, there was a statistically significant association with  (p=0.003) duration of diabetes and frequency of IA-2A. Conclusion: This study concluded that presence of autoantibodies such as insulinoma-associated antigen-2 autoantibodies, Insulin autoantibodies and glutamic acid decarboxylase 65 were found to be predominant in males than females although it was not significantly associated with age and gender. Additionally, presence of insulinoma-associated antigen-2 autoantibodies, Insulin autoantibodies significantly associated with the duration of disease.
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