成人隐匿性自身免疫性糖尿病与自身免疫性甲状腺疾病

[Adult-onset latent autoimmune diabetes and autoimmune thyroid disease].

作者信息

Jin Ping, Zhou Zhi-guang, Yang Lin, Yan Xiang, Wang Jian-ping, Zhang Dong-mei, Huang Gan

机构信息

Institute of Endocrinology and Metabolism, the Second Xiangya Hospital of Central South University, Changsha 410011, China.

出版信息

Zhonghua Nei Ke Za Zhi. 2004 May;43(5):363-7.

PMID:15182509

Abstract

OBJECTIVE

To investigate the relationship between latent autoimmune diabetes in adults (LADA) and thyroid autoimmunity.

METHODS

The frequency of thyroid peroxidase antibody (TPO-Ab) and thyroglobulin antibody (TG-Ab) was determined with radioimmunoassay in 394 subjects, including 90 LADA, 104 classic type 1 diabetics (T1DM), 100 type 2 diabetics (T2DM) and 100 controls. Glutamic acid decarboxylase antibody (GAD-Ab) was measured with radioligand immunoassay.

RESULTS

(1) TPO-Ab existed more frequently in LADA (16.7%, 15/90) than in T2DM patients (7.0%, 7/100; P < 0.05). The frequency of thyroid antibody (TPO-Ab or TG-Ab positivity) in LADA and T1DM was 18.9% (17/90) and 25.0% (26/104) respectively, being higher than that in the control group (8/100, 8.0%; P < 0.05). (2) Thyroid antibodies occurred more frequently in LADA patients with higher titer of GAD-Ab (GAD-Ab > or = 0.5) than those with lower ones (50.0% vs 12.5%, P < 0.05). (3) 47.1% (8/17) of LADA patients with thyroid autoimmunity had thyroid dysfunction as compared with 17.6% (6/34) in the group without thyroid antibodies (P < 0.05).

CONCLUSIONS

(1) LADA patients, especially those with high titer of GAD-Ab, have high risk for thyroid autoimmunity. (2) The presence of thyroid antibody may predict high risk for thyroid dysfunction in LADA patients. (3) LADA may be one of the components in autoimmune polyendocrine syndrome.

摘要

目的

探讨成人隐匿性自身免疫性糖尿病（LADA）与甲状腺自身免疫之间的关系。

方法

采用放射免疫分析法测定394例受试者的甲状腺过氧化物酶抗体（TPO-Ab）和甲状腺球蛋白抗体（TG-Ab）水平，其中包括90例LADA患者、104例经典1型糖尿病患者（T1DM）、100例2型糖尿病患者（T2DM）和100例对照者。采用放射配体免疫分析法测定谷氨酸脱羧酶抗体（GAD-Ab）水平。

结果

（1）LADA患者中TPO-Ab的出现频率（16.7%，15/90）高于T2DM患者（7.0%，7/100；P<0.05）。LADA和T1DM患者中甲状腺抗体（TPO-Ab或TG-Ab阳性）的频率分别为18.9%（17/90）和25.0%（26/104），高于对照组（8/100，8.0%；P<0.05）。（2）GAD-Ab滴度较高（GAD-Ab≥0.5）的LADA患者中甲状腺抗体的出现频率高于滴度较低者（50.0%对12.5%，P<0.05）。（3）有甲状腺自身免疫的LADA患者中47.1%（8/17）存在甲状腺功能障碍，而无甲状腺抗体组为17.6%（6/34）（P<0.05）。