The Expression And Diagnostic Value Of Gad-ab,ica,iaa In Lada

Objective:To investigate the general clinical and biochemical characteristics of type 2 diabetic patients with glutamic acid decarboxylase antibodies (GAD-Ab),islet cell antibodies (ICA) and insulin autoantibodies (IAA); to study the prevalence rate of latent autoimmune diabetes in adults (LADA) and to disclose the value of these autoantibodies in the diagnosis of LADA; and to study the factors for islet cell function in LADA.Methods:GAD-Ab,ICA,IAA in serum were determined by ELISA in both 110 patients with type 2 diabetes and 40 normal controls.And to investigate the general clinical and biochemical characteristics in the 110 type 2 diabetic patients.Results:There was 17.3% GAD-Ab positive ratio in 110 patients with type 2 diabetes,12.7% ICA positive and 4.5% IAA.20.9% positive ratio in combining the measure of GAD-Ab and ICA.Compared with autoantibodies negative group, age at onset of LADA,DBP,TG were significantly lower (P<0.01),age,C peptide were also lower (P<0.05) while much more ketosis and much more therapy with insulin(P<0.01).There were no significant difference among the two groups in sex,duration,SBP,plasma TC,FPG,2HPG and HbA1c.Althrough there was no significant difference among the two groups in BMI, the proportion of BMI<21 kg/m2 was lower in antibodies positive group (P<0.05). Spearman single factor regression analysis showed that FCP,2HCP had positive correlation with age at onse,BMI and negative correlation with duration,HbA1c,FPG.They had no association with age,2HPG,TC,TG,SBP,DBP.Multiple stepwise regression analysis showed that BMI (rs=0.632, P<0.01),HbA1c (rs=-0.555, P<0.01) were correlated with FCP levels and BMI (rs=0.451, P<0.05) was positively correlated with 2HCP levels. Conclusion:The patients initially diagnosed as type 2 diabetes mellitus may actually be LAD A. The clinic characters in LADA patients are different from those in type 2 diabetes. The important clues for the diagnosis of LADA may include lower age,lower age at onset,lower BMI,lower C peptide level,lower DBP and TG, ketotic history and a large dose of insulin was used in treating patients. Combined detecting GAD-Ab and ICA can improve the diagnostic sensitivity of LADA.It is important to synthetically analysis islet cell function in LADA.