Connor E, Silverstein J, Maclaren N
Department of Pediatrics, University of Florida College of Medicine, Gainesville.
J Fla Med Assoc. 1991 Nov;78(11):739-42.
Insulin dependent diabetes (IDD) most often results from the autoimmune destruction of pancreatic beta cells. During this process, autoantibodies to islet cell constituents (islet cell cytoplasm, 64KDa protein [GAD]) and to insulin arise and can be used for disease prediction if found before onset or for classification at onset in cases in which type of diabetes is not clear. Approximately 4-5% of immediate family members have at least one of these antibodies. The younger the age and the higher the antibody titer, the greater the chance of IDD developing. Because studies using immunosuppression in newly-diagnosed IDD have shown transient prolongation of beta cell function, efforts to use such therapies prior to diabetes onset may prevent beta cell destruction and clinical disease. A multicenter trial is underway in Florida to screen relatives for diabetes-related antibodies and then to enter those found positive and at increased risk in a study to prevent diabetes. Details of the study and its rationale are presented.
胰岛素依赖型糖尿病（IDD）通常是由胰腺β细胞的自身免疫性破坏引起的。在此过程中，会产生针对胰岛细胞成分（胰岛细胞质、64KDa蛋白[谷氨酸脱羧酶]）和胰岛素的自身抗体，如果在发病前发现这些抗体，可用于疾病预测；对于糖尿病类型不明确的病例，在发病时可用于分类。大约4-5%的直系家庭成员至少有一种此类抗体。年龄越小、抗体滴度越高，患IDD的几率就越大。由于在新诊断的IDD中使用免疫抑制的研究表明β细胞功能有短暂延长，因此在糖尿病发病前使用此类疗法可能会预防β细胞破坏和临床疾病。佛罗里达州正在进行一项多中心试验，筛查亲属是否存在与糖尿病相关的抗体，然后让检测呈阳性且患病风险增加的人参加一项预防糖尿病的研究。本文介绍了该研究的详细情况及其基本原理。
