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2型糖尿病成年患者中潜在自身免疫性糖尿病患者的常见自身免疫生物标志物、甲状腺激素异常及β细胞功能障碍

Common autoimmune biomarkers, thyroid hormonal abnormalities, and beta cells dysfunction in patients with latent autoimmune diabetes in adults with type II diabetes mellitus.

作者信息

Yousefzadeh Gholamreza, Gozashti Mohammadhossein, Najafipour Hamid, Gholamhosseinian Najar Ahmad, Bahramnejad Abbas, Shokouhi Mostafa

机构信息

Department of Endocrinology, Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.

Department of Endocrinology, Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.

出版信息

Diabetes Metab Syndr. 2016 Jan-Mar;10(1 Suppl 1):S52-5. doi: 10.1016/j.dsx.2015.09.013. Epub 2015 Oct 9.

Abstract

AIM

Latent autoimmune diabetes in adults (LADA) is autoimmune diabetes with a slow progression characterized by the presence of antibodies associated with Type I diabetes. The present study aimed to assess autoimmune characteristics in patients with LADA in Iran. We attempted to obtain a clear view of autoimmune conditions in LADA among our population.

METHODS

This study was sourced from the population-based survey of KERCARDS aiming assessment of cardiovascular risk factors among a great sample of Iranian population who were resident in Kerman, a great province in southern Iran. Among all diabetic patients who were negative for Anti Glutamic Acid Decarboxylase (GAD) antibody test, 120 were selected as the controls and among 80 patients who were positive for this test diagnosed as LADA, the recorded files of 57 patients were complete considered as the cases.

RESULTS

The level of thyroxin is significantly lower in patients with LADA compared with the controls so 73.7% and 45% of patients had normal level of thyroxin, respectively. Also, those with LADA had considerably lower levels of both thyroid peroxydaseantibody (TPO-Ab) and C-peptide when compared with non-LADA group. Using multivariate analyses and with the presence of baseline variables including gender, age, and duration of disease, the diagnosis of LADA was associated with lower serum levels of Anti-TPO, C-peptide, and thyroxin, but not associated with the level of Anti-TTG in serum.

CONCLUSION

LADA patients may face with lower serum levels of C-peptide and thyroid-specific antibodies indicating insulin therapy requirement and authoimmune fundaments of the disease, respectively.

摘要

目的

成人隐匿性自身免疫性糖尿病(LADA)是一种进展缓慢的自身免疫性糖尿病,其特征是存在与1型糖尿病相关的抗体。本研究旨在评估伊朗LADA患者的自身免疫特征。我们试图清楚了解我们人群中LADA患者的自身免疫状况。

方法

本研究源自KERCARDS基于人群的调查,旨在评估居住在伊朗南部大省克尔曼的大量伊朗人群中的心血管危险因素。在所有抗谷氨酸脱羧酶(GAD)抗体检测呈阴性的糖尿病患者中,选择120例作为对照,在80例该检测呈阳性且被诊断为LADA的患者中,将57例记录文件完整的患者视为病例。

结果

LADA患者的甲状腺素水平显著低于对照组,因此分别有73.7%和45%的患者甲状腺素水平正常。此外,与非LADA组相比,LADA患者的甲状腺过氧化物酶抗体(TPO-Ab)和C肽水平均显著较低。使用多变量分析,并考虑包括性别、年龄和病程在内的基线变量,LADA的诊断与血清中抗TPO、C肽和甲状腺素水平较低有关,但与血清中抗TTG水平无关。

结论

LADA患者可能面临血清C肽水平和甲状腺特异性抗体水平较低的情况,分别表明需要胰岛素治疗以及该疾病的自身免疫基础。

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