Lindberg B, Ivarsson S A, Landin-Olsson M, Sundkvist G, Svanberg L, Lernmark A
Department of Paediatrics, Malmö University Hospital, Sweden.
Diabetologia. 1999 Feb;42(2):181-7. doi: 10.1007/s001250051137.
Islet autoantibodies are early markers for Type I (insulin-dependent) diabetes mellitus. The aim of this study was to establish whether islet autoantibodies were present at birth in children who developed Type I diabetes before 15 years of age. Cord blood sera from 81 children who developed Type I diabetes between 10 months and 14.9 years of age were tested for glutamic acid decarboxylase autoantibodies (GAD65Ab), islet cell antigen 512 autoantibodies (ICA512Ab), insulin autoantibodies (IAA) all by quantitative radioligand binding assays and islet cell autoantibodies (ICA) by indirect immunofluorescence. Cord blood sera from 320 randomly selected matched children were controls. The children who developed Type I diabetes had an increased frequency of cord blood islet autoantibodies compared with control subjects: Glutamic acid decarboxylase autoantibodies were detected in 6% (5/81) patients and 2% (5/320) control subjects (p = 0.03); islet cell antigen 512 autoantibodies in 5% (4/73) patients and 1% (4/288) control subjects (p = 0.06); insulin autoantibodies (IAA) in 0% (0/79) patients and 0.3% (1/320) control subjects (p = 0.36); and islet cell autoantibodies in 10% (8/81) patients compared with 0.6% (2/320) control subjects (p = 0.0001). Taken together, 17% (14/81) patients had one or more islet autoantibody compared with 4% (12/320) control subjects (p = 0.0001). Whereas none of the control children had more than one antibody, 4% (3/81) children who later developed Type I diabetes were double positive (p = 0.002). Although glutamic acid decarboxylase autoantibodies' concentrations in cord-blood correlated to those in the mothers' blood at the time of delivery, no corresponding correlation was found for the other two types of autoantibodies. The increased frequency of cord blood islet autoantibodies suggests that the Type I diabetes process could already be initiated in utero.
胰岛自身抗体是I型（胰岛素依赖型）糖尿病的早期标志物。本研究的目的是确定15岁前患I型糖尿病的儿童出生时是否存在胰岛自身抗体。对81名10个月至14.9岁患I型糖尿病儿童的脐血血清进行谷氨酸脱羧酶自身抗体（GAD65Ab）、胰岛细胞抗原512自身抗体（ICA512Ab）、胰岛素自身抗体（IAA）检测，均采用定量放射配体结合测定法，胰岛细胞自身抗体（ICA）采用间接免疫荧光法检测。320名随机选取的匹配儿童的脐血血清作为对照。与对照受试者相比，患I型糖尿病儿童的脐血胰岛自身抗体频率增加：6%（5/81）的患者检测到谷氨酸脱羧酶自身抗体，对照受试者为2%（5/320）（p = 0.03）；5%（4/73）的患者检测到胰岛细胞抗原512自身抗体，对照受试者为1%（4/288）（p = 0.06）；0%（0/79）的患者检测到胰岛素自身抗体，对照受试者为0.3%（1/320）（p = 0.36）；10%（8/81）的患者检测到胰岛细胞自身抗体，对照受试者为0.6%（2/320）（p = 0.0001）。总体而言，17%（14/81）的患者有一种或多种胰岛自身抗体，对照受试者为4%（12/320）（p = 0.0001）。对照儿童均无一种以上抗体，而4%（3/81）后来患I型糖尿病的儿童为双阳性（p = 0.002）。虽然脐血中谷氨酸脱羧酶自身抗体的浓度与分娩时母亲血液中的浓度相关，但未发现其他两种自身抗体有相应的相关性。脐血胰岛自身抗体频率增加表明I型糖尿病进程可能在子宫内就已开始。
