Evaluatio Of A Immunobloting Method Of GADA, ICA, And IAA Detection & Its Application To The Clinical Diagnosis Of LADA

According to WHO diabetes diagnostic and minute standard of year 1999, LADA belongs to one genre of type 1 diabetes [1]. Various reports of the LADA accounts for type 2 diabetic's proportion are different due to different judgment standard, and comprehensive literature analysis generally are about 10%-20%. At present, the sensitivity and the accuracy of relevant immune body determination methods are not extremely ideal due to lack of room quality control. Therefore, it is extremely essential to evaluate a method before it is used for clinical.Objective:In our hospital, since January, 2007, Immunoblotting Method has been used to examine the diabetes patients'glutamicacid decarboxylase antibody (GADA), islet cell antibody (ICA), and insulin autoantibody (IAA).This research is for the purpose of analyzing the pertinence of the examine result of this method and diabetes clinical characteristic, and then evaluate its importance in the LADA diagnose. Simultaneously, examines thyroid peroxide enzyme autoantibody (TPO-Ab), and analysis whether examining TPO-Ab can help to diagnose LADA.Methods:Select the diabetics in our hospital from January to April, 2007 (all cases meet WHO diabetes diagnostic and minute standard of year 1999). Age 15~75 years old. Record the patients'the sex, the age, the height, the weight, the blood pressure (BP), the waist, and the hips. Calculate the body weight index, the waist buttocks ratio. Draw thevenous blood, determinate faster blood sugar (FPG), glycerin (TG), total cholesterol (TC), faster and meal the insulin, the C peptide (FINS,PINS,FCP,PCP), the dissociation thyroxin (FT4), drifts away three idodine armor gland original ammonia acid (FT3), presses thyroxine (TSH), TPO-Ab, saccharification hemoglobin (HbAlc), GADA, ICA, IAA. According to morbidity age, whether there is diabetes family history, whether doesn't have the cause to appear the alkone sickness and so on the clinical characteristics to divide into two groups , the model 1 diabetes group and 2 diabetes group. Then according to the difference of GADA, ICA, and IAA, divides 2 diabetes groups into the immune body negative group and the immune body masculine group. Analyze these three groups of patient's clinical characteristics, the biochemistry characteristic, the island of pancreas function, GADA, ICA, IAA masculine rate, each group of TPO-Ab observed value, and the relativity between TPO-Ab and GADA, ICA, IAA.Results:1,102 patients, only one type 1 diabetes, its immune body are all masculine;101 T2DM patients, ICA masculine rate (30%)> GADA masculine rate (15%) >IAA masculine rate (1%).2, Clinical characteristics(1) Immune body masculine group's general clinical characteristic such as age, the morbidity age, the course of an illness, BMI, WHR, HOMA-β,HOMA-IR,diabetes chronic complication formation rate, the fatty liver formation rate and so on have the much difference with the model 1 diabetes, but approaches in the immune body negative 2 diabetic.(2) Immune body negative group has the more insulin resistance tendency than the others.3, TPO-Ab examination: The immune body negative group's