Analysis Of Clinicle Characteristics Of Exogenous Insulin Autoimmune Syndrome

Objective: Analyze and summarize the clinical features of exogenous insulin autoimmune syndrome(Exogenous insulin autoimmune syndrome,EIAS),explore the effect of different insulin on insulin antibody(Insulin antibody,IA),and predict the reference threshold of positive insulin antibody.Methods: Selected patients with diabetes who were hospitalized in the fifth affiliated hospital of Xinjiang Medical University between 2021 and 2022,and who were positive(N= 123)or negative(n = 123)insulin antibody after using insulin or Insulin analog,the general data and biochemical indexes were collected,and the clinical characteristics and influencing factors of the two groups were analyzed retrospectively.Wps-excel software was used to make the original data table,SPSS 25.0 software was used to describe and analyze the data.The test level of analysis was 0.05.Results: BMI,insulin injection dose,times of insulin injection,fasting blood glucose,fasting insulin,fasting insulin/c-peptide ratio,2-hour postprandial insulin and2-hour postprandial insulin/c-peptide ratio,incidence of hypoglycemia were significantly different between insulin antibody positive group and insulin antibody negative group(P< 0.05).There were significant differences between basal insulin and premixed insulin,basal insulin and basal + short-acting insulin(P<0.008).The sensitivity and specificity of fasting insulin/c-peptide ratio as a predictor of insulin antibody positivity were 0.826 and 0.778,respectively the sensitivity and specificity of the 2-hour postprandial insulin/c-peptide ratio as a predictor of insulin antibody positivity were 0.739 and0.778,respectively,with a cut-off of 7.27 for the corresponding ratio at the peak of the Youden Index.Conclusion: Insulin antibody positive patients had higher BMI,insulin injection dose,insulin injection times,fasting blood glucose,fasting insulin,fasting insulin/c-peptide ratio,2-hour postprandial insulin and 2-hour postprandial insulin/c-peptide ratio.The incidence of hypoglycemia in insulin antibody positive patients was higher than that in insulin antibody negative patients.Compared with basal insulin,premixed insulin and basal + short-acting insulin regimens have a higher risk of insulin antibody positivity.The ratio of insulin/c-peptide has diagnostic value for insulin antibody positivity,and the critical value of fasting insulin/c-peptide ratio as a reference for predicting insulin antibody positivity is 4.51;The 2-hour postprandial insulin/c-peptide ratio was 7.27.