Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, South Korea.
Diabet Med. 2011 Mar;28(3):319-24. doi: 10.1111/j.1464-5491.2010.03186.x.
To investigate the rate of progression to insulin deficiency in Korean patients with Type 2 diabetes mellitus positive for anti-GAD antibody (GADA) and to determine the factors related to progression to insulin deficiency.
We retrospectively analysed data on 87 GADA-positive and 87 age- and sex-matched GADA-negative patients with Type 2 diabetes. GADA-positive patients were further subclassified into high-titre (≥ 250 WHO units/ml) (n = 24) and low-titre (< 250 WHO units/ml) (n = 63) subgroups. Cox proportional hazard analysis was used to identify factors associated with progression to insulin deficiency.
Over a period of 6 years, two of 87 (2.3%) GADA-negative and 37 of 87 (42.5%) GADA-positive patients had progressed to insulin deficiency. The rate of progression to insulin deficiency was higher in the high-titre than in the low-titre subgroup (75.0 vs. 30.2%). Multivariate analysis in GADA-positive patients showed that high-titre GADA and low BMI at diagnosis were independent factors significantly related to progression to insulin deficiency.
The presence of GADA predicted the progression to insulin deficiency in Korean patients with Type 2 diabetes. In GADA-positive patients, high-titre GADA and low BMI were associated with this progression.
研究抗谷氨酸脱羧酶抗体（GADA）阳性的 2 型糖尿病患者发生胰岛素缺乏的进展率，并确定与胰岛素缺乏进展相关的因素。
我们回顾性分析了 87 例 GADA 阳性和 87 例年龄和性别匹配的 GADA 阴性 2 型糖尿病患者的数据。GADA 阳性患者进一步分为高滴度（≥250 WHO 单位/ml）（n=24）和低滴度（<250 WHO 单位/ml）（n=63）亚组。使用 Cox 比例风险分析来确定与胰岛素缺乏进展相关的因素。
在 6 年的时间里，87 例 GADA 阴性患者中有 2 例（2.3%）和 87 例 GADA 阳性患者中有 37 例（42.5%）进展为胰岛素缺乏。高滴度组的胰岛素缺乏进展率高于低滴度组（75.0%比 30.2%）。在 GADA 阳性患者中，多变量分析显示高滴度 GADA 和诊断时低 BMI 是与胰岛素缺乏进展显著相关的独立因素。
GADA 的存在可预测韩国 2 型糖尿病患者发生胰岛素缺乏。在 GADA 阳性患者中，高滴度 GADA 和低 BMI 与这种进展相关。
