Fakhfakh R, Haddouk S, Hadj Hamida Y B, Kamoun T, Ayed M B, Hachicha M, Masmoudi H
Immunology Department, Habib Bourguiba Hospital, 3029 Sfax, Tunisia.
Pathol Biol (Paris). 2008 May;56(3):130-2. doi: 10.1016/j.patbio.2007.09.019. Epub 2008 Jan 4.
We analyzed 86 children with newly diagnosed type 1 diabetes for antibodies to islet cells (ICA), glutamic acid decarboxylase (GADA), second-islet antigen (IA-2A), and insulin (IAA) in order to evaluate the prevalence of immune-mediated type 1 diabetes, as well as to recognize which autoantibody combination is more frequently associated with the disease. A positive result for one or more diabetes-related antibodies evaluated was found in 78 children (90.7%). With regard to single autoantibody testing, ICA were found to be positive in 49 patients (57%), GADA in 56 (65.1%), IA-2A in 37 (43%), and IAA in 43 (50%) patients. Combining the determination of at least two autoantibodies, GADA and/or IAA were better detectable than other antibody combination, being positive in 70 patients (81.4%). GADA and IA-2A represent also a useful screening combination; being positive in 65 patients (75.6%). Our data indicate that the vast majority of cases of type 1 diabetes in children may be considered as immune-mediated and that multiple autoantibody analysis improves identification of the disease.
我们分析了86例新诊断的1型糖尿病患儿的胰岛细胞抗体（ICA）、谷氨酸脱羧酶抗体（GADA）、第二胰岛抗原抗体（IA - 2A）和胰岛素自身抗体（IAA），以评估免疫介导的1型糖尿病的患病率，并确定哪种自身抗体组合与该疾病的关联更为频繁。在78例患儿（90.7%）中发现一种或多种所检测的糖尿病相关抗体呈阳性。在单项自身抗体检测中，49例患者（57%）的ICA呈阳性，56例（65.1%）的GADA呈阳性，37例（43%）的IA - 2A呈阳性，43例（50%）的IAA呈阳性。联合检测至少两种自身抗体时，GADA和/或IAA比其他抗体组合更容易检测到，70例患者（81.4%）呈阳性。GADA和IA - 2A也是一种有用的筛查组合，65例患者（75.6%）呈阳性。我们的数据表明，儿童1型糖尿病的绝大多数病例可能被视为免疫介导的，并且多种自身抗体分析可提高对该疾病的识别。
