Endocrinology and Diabetes, Department of Medical Sciences, University of Cagliari, Cagliari, Italy.
Diabetes Care. 2010 Apr;33(4):820-2. doi: 10.2337/dc09-1573. Epub 2009 Dec 29.
Little is known about the prevalence of beta-cell autoantibodies in children with excess body weight. The prevalence of type 1 diabetes autoantibodies and its relation with hyperglycemia was analyzed in 686 overweight/obese children and adolescents.
All children underwent an oral glucose tolerance test, and anti-GAD, anti-IA2, and anti-IAA autoantibodies were measured. Autoantibody prevalence was evaluated in 107 normal-weight children for comparison.
A single autoantibody was present in 2.18% of overweight/obese subjects and 1.86% normal-weight subjects (P = NS). Postload glycemia was significantly higher in antibody-positive children (133 +/- 69.9 vs. 105.4 +/- 17.7 mg/dl, P < 0.0001) compared with autoantibody-negative subjects. No difference in autoantibody distribution was seen when our cohort was stratified by age, sex, SDS-BMI, pubertal stage, and homeostasis model assessment-insulin resistance (HOMA-IR).
The 2.18% prevalence of type 1 diabetes autoantibodies is similar to that reported in nonobese children. This study provided evidence that excess body weight and insulin resistance do not influence autoantibody frequency.
肥胖儿童胰岛β细胞自身抗体的流行情况尚不清楚。本研究旨在分析超重/肥胖青少年人群中 1 型糖尿病自身抗体的流行情况及其与高血糖的关系。
所有儿童均行口服葡萄糖耐量试验(OGTT),并检测谷氨酸脱羧酶(GAD)、胰岛细胞抗原 2(IA2)和胰岛素自身抗体(IAA)。为了进行比较,我们还在 107 名正常体重儿童中评估了自身抗体的流行情况。
在超重/肥胖组中,有 2.18%的儿童存在 1 种自身抗体,而在正常体重组中该比例为 1.86%(P=NS)。与自身抗体阴性者相比,抗体阳性者的负荷后血糖明显更高(133+/-69.9 与 105.4+/-17.7mg/dl,P<0.0001)。当我们按照年龄、性别、BMI-SDS、青春期阶段和稳态模型评估的胰岛素抵抗(HOMA-IR)对研究队列进行分层时,并未发现自身抗体分布存在差异。
1 型糖尿病自身抗体的 2.18%流行率与非肥胖儿童报道的相似。本研究结果提示超重/肥胖和胰岛素抵抗并不影响自身抗体的频率。