Catalano P M, Tyzbir E D, Sims E A
Department of Obstetrics and Gynecology, University of Vermont College of Medicine, Burlington.
Diabetes Care. 1990 May;13(5):478-82. doi: 10.2337/diacare.13.5.478.
Islet cell antibodies (ICAs) are markers for patients at risk for insulin-dependent diabetes and are associated with progressive beta-cell destruction. This prospective study was performed to estimate the incidence of these antibodies in 187 women with previous gestational diabetes. With a specific protein A monoclonal antibody (MoAb) assay, the incidence of ICAs was only 1.6% (3 of 187). Oral and intravenous glucose tolerance tests were performed in these 3 women and compared with 6 women with previous gestational diabetes without ICAs and 5 control women. Glucose tolerance was impaired only in the 3 women with ICAs, who also had an increase (P less than 0.03) in fasting plasma glucose and a decrease (P less than 0.03) in early first-phase insulin response. We conclude that the more specific MoAb method indicates a lower incidence of ICA in women with a history of gestational diabetes than previously reported and that a decreased first-phase insulin response is associated with the presence of ICAs, suggesting progressive islet cell damage.
胰岛细胞抗体（ICAs）是胰岛素依赖型糖尿病高危患者的标志物，与进行性β细胞破坏相关。本前瞻性研究旨在评估187例既往有妊娠期糖尿病的女性中这些抗体的发生率。采用特异性蛋白A单克隆抗体（MoAb）检测法，ICA的发生率仅为1.6%（187例中有3例）。对这3名女性进行了口服和静脉葡萄糖耐量试验，并与6名既往有妊娠期糖尿病但无ICA的女性以及5名对照女性进行了比较。仅3名有ICA的女性糖耐量受损，她们的空腹血糖也有所升高（P<0.03），早期第一相胰岛素反应有所降低（P<0.03）。我们得出结论，更特异的MoAb方法表明，有妊娠期糖尿病史的女性中ICA的发生率低于先前报道，并且第一相胰岛素反应降低与ICA的存在相关，提示胰岛细胞进行性损伤。
