Dereke Jonatan, Nilsson Charlotta, Strevens Helena, Landin-Olsson Mona, Hillman Magnus
Lund University, Department of Clinical Sciences, Diabetes Research Laboratory, Lund, Sweden.
Lund University, Department of Clinical Sciences, Diabetes Research Laboratory, Lund, Sweden; Helsingborg Hospital, Department of Pediatrics, Helsingborg, Sweden.
Clin Immunol. 2016 Jan;162:45-8. doi: 10.1016/j.clim.2015.11.001. Epub 2015 Nov 5.
Some women with gestational diabetes (GDM) present with autoantibodies associated with type 1 diabetes. These are usually directed against glutamic acid decarboxylase (GADA) and suggested to predict development of type 1 diabetes. The primary aim of this study was to investigate if GADA IgG subclasses at onset of GDM could assist in predicting postpartum development. Of 1225 women diagnosed with first-time GDM only 51 were GADA-positive. Total GADA was determined using ELISA. GADA subclasses were determined with radioimmunoassay. Approximately 25% of GADA-positive women developed type 1 diabetes postpartum. Titers of total GADA were higher in women that developed type 1 diabetes (142.1 vs 74.2u/mL; p=0.04) and they also had lower titers of GADA IgG4 (index=0.01 vs 0.04; p=0.03). In conclusion we found that that women with high titers of total GADA but low titers of GADA IgG4 were more prone to develop type 1 diabetes postpartum.
一些患有妊娠期糖尿病（GDM）的女性体内存在与1型糖尿病相关的自身抗体。这些抗体通常针对谷氨酸脱羧酶（GADA），并被认为可预测1型糖尿病的发展。本研究的主要目的是调查GDM发病时的GADA IgG亚类是否有助于预测产后病情发展。在1225名首次诊断为GDM的女性中，只有51名GADA呈阳性。采用酶联免疫吸附测定法（ELISA）测定总GADA。用放射免疫测定法测定GADA亚类。约25%的GADA阳性女性产后发展为1型糖尿病。发展为1型糖尿病的女性总GADA滴度更高（142.1对74.2u/mL；p=0.04），且她们的GADA IgG4滴度也更低（指数=0.01对0.04；p=0.03）。总之，我们发现总GADA滴度高但GADA IgG4滴度低的女性产后更易发展为1型糖尿病。
