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谷氨酸脱羧酶抗体滴度在区分成人隐匿性自身免疫性糖尿病两种亚型中的最佳截断点

Optimal cutoff point of glutamate decarboxylase antibody titers in differentiating two subtypes of adult-onset latent autoimmune diabetes.

作者信息

Li X, Zhou Z G, Huang G, Yan X, Yang L, Chen X Y, Wang J P

机构信息

Diabetes Center, Second Xiangya Hospital, Central South University, 139 Renmin Zhong Road, Changsha, Hunan 410011, China.

出版信息

Ann N Y Acad Sci. 2004 Dec;1037:122-6. doi: 10.1196/annals.1337.019.

Abstract

The optimal cutoff point of glutamate decarboxylase antibody (GAD-Ab) titers for differentiating two latent autoimmune diabetes (LADA) subtypes remains unclear. One hundred and forty-five GAD-Ab-positive patients screened from phenotypic type 2 diabetes were diagnosed as LADA. The clinical features were compared among LADA patients with different GAD-Ab titers. The receiver-operating characteristic (ROC) curve was used to evaluate the diagnostic value of GAD-Ab titers and to define the optimal cutoff point. The heterogeneity of clinical features in LADA could be discriminated by five GAD-Ab titers, with maximal differences at the titer of 175 U/mL. The ROC curve analysis showed that the optimal cutoff point for discriminating two LADA subtypes was at the titer of 175 U/mL, with sensitivity and specificity of 54.5% and 92.1%, respectively. These findings demonstrated that the two clinically distinct subtypes of LADA can be optimally discriminated by the GAD-Ab titers.

摘要

谷氨酸脱羧酶抗体(GAD-Ab)滴度用于区分两种潜在自身免疫性糖尿病(LADA)亚型的最佳截断点仍不明确。从2型糖尿病表型患者中筛选出145例GAD-Ab阳性患者并诊断为LADA。比较了不同GAD-Ab滴度的LADA患者的临床特征。采用受试者工作特征(ROC)曲线评估GAD-Ab滴度的诊断价值并确定最佳截断点。LADA临床特征的异质性可通过5个GAD-Ab滴度进行区分,在滴度为175 U/mL时差异最大。ROC曲线分析表明,区分两种LADA亚型的最佳截断点为175 U/mL,敏感性和特异性分别为54.5%和92.1%。这些发现表明,两种临床特征不同的LADA亚型可通过GAD-Ab滴度得到最佳区分。

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