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1型糖尿病患者抗中性粒细胞胞浆自身抗体(ANCA)的评估

[Assessment of antineutrophil-cytoplasmic autoantibodies (ANCA) in type 1 diabetic patients].

作者信息

Schlaffke Judyta, Zozulińska Dorota, Wierusz-Wysocka Bogna

机构信息

Klinika Chorób Wewnetrznych i Diabetologii Wydziału Nauk o Zdrowiu AM im K Marcinkowskiego w Poznaniu.

出版信息

Pol Arch Med Wewn. 2005 Jun;113(6):552-6.

Abstract

Polymorphonuclear neutrophils and inflammatory process play a key role in the development of late diabetic vascular complications. Antineutrophil-cytoplasmic autoantibodies (ANCA) are considered important serological markers for vasculitis. The aim of study was the assessment of prevalence ANCA in type 1 diabetic patients and evaluation of the relationship between ANCA and diabetic microangiopathy. 94 type 1 diabetic subjects, 47 male and 47 female, aged 30.7 +/- 9.6 years, with mean duration of diabetes 9.5 +/- 6.8 years and HbA1c 7.9 +/- 1.3% were included to this study. ANCA were detected by the indirect immunofluorescence test and the specificity was evaluated by ELISA test. The significantly positive result of ANCA was noticed in 11 subjects (12%), anti-myeloperoxidase (anti-MPO) in 9 and anti-proteinase 3 (anti-Pr-3c) in 2 subjects. It was not observed any differences in sex, parameters of metabolic control, duration of diabetes, C-reactive protein levels and diabetic retinopathy and nephropathy between group with ANCA and without ANCA (p>0.05). Moreover, we did not notice relationship between ANCA and the risk of late diabetic complications (retinopathy: OR 1.64; 95% CI 0.46-5.82, p = 0.52 and nephropathy: OR 0.16; 95% CI 0.02-1.35, p = 0.10). The obtained results do not fully confirm hypothesis that ANCA are connected with the development of diabetic microangiopathy.

摘要

多形核中性粒细胞和炎症过程在晚期糖尿病血管并发症的发生发展中起关键作用。抗中性粒细胞胞浆抗体(ANCA)被认为是血管炎的重要血清学标志物。本研究的目的是评估1型糖尿病患者中ANCA的患病率,并评估ANCA与糖尿病微血管病变之间的关系。本研究纳入了94例1型糖尿病患者,其中男性47例,女性47例,年龄30.7±9.6岁,糖尿病平均病程9.5±6.8年,糖化血红蛋白(HbA1c)为7.9±1.3%。通过间接免疫荧光试验检测ANCA,并通过酶联免疫吸附测定试验评估其特异性。11例受试者(12%)的ANCA检测结果呈显著阳性,其中9例为抗髓过氧化物酶(抗MPO)阳性,2例为抗蛋白酶3(抗Pr-3c)阳性。在ANCA阳性组和阴性组之间,未观察到性别、代谢控制参数、糖尿病病程、C反应蛋白水平以及糖尿病视网膜病变和肾病方面的差异(p>0.05)。此外,我们未发现ANCA与晚期糖尿病并发症风险之间存在关联(视网膜病变:比值比[OR]1.64;95%置信区间[CI]0.46 - 5.82,p = 0.52;肾病:OR 0.16;95% CI 0.02 - 1.35,p = 0.10)。所得结果并未完全证实ANCA与糖尿病微血管病变的发生有关这一假设。

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