Stutchfield P R, O'Halloran S M, Smith C S, Woodrow J C, Bottazzo G F, Heaf D
Department of Child Health, Royal Liverpool Children's Hospital Alder Hey, London.
Arch Dis Child. 1988 Oct;63(10):1234-9. doi: 10.1136/adc.63.10.1234.
Impaired glucose tolerance, assessed by a raised glycated haemoglobin (HbA1) concentration, was found in 24 (39%) out of 61 patients with cystic fibrosis with an age range of 1-23 years. No correlation between age and HbA1 concentration was found indicating that factors other than progressive pancreatic fibrosis may be important in the aetiology. HLA typing, islet cell antibodies, and autoantibody screen were completed. Eighteen (75%) out of 24 patients with cystic fibrosis who had an impaired glucose tolerance had HLA-DR3 or HLA-DR4 antigens compared with 23 (62%) out of 37 patients with normal glucose tolerance. Islet cell antibodies were present in seven (15%) out of 46 patients with cystic fibrosis; the prevalence in a normal population is 0.5%. Five (25%) of the 20 patients with a raised HbA1 concentration were positive for islet cell antibodies compared with two (8%) out of the 26 with normal glucose tolerance. Six (86%) out of seven patients who were positive for islet cell antibodies had HLA-DR3 or HLA-DR4 antigens. There was no general autoantibody production. Islet cell antibodies may play a part in the development of glucose intolerance in some patients with cystic fibrosis by being produced in those who are genetically predisposed as part of an immune response to damaged pancreatic tissue.
在61例年龄为1至23岁的囊性纤维化患者中，通过糖化血红蛋白（HbA1）浓度升高评估发现，24例（39%）存在糖耐量受损。未发现年龄与HbA1浓度之间存在相关性，这表明除进行性胰腺纤维化外的其他因素在病因学中可能很重要。完成了HLA分型、胰岛细胞抗体和自身抗体筛查。24例糖耐量受损的囊性纤维化患者中有18例（75%）具有HLA - DR3或HLA - DR4抗原，而37例糖耐量正常的患者中有23例（62%）具有这些抗原。46例囊性纤维化患者中有7例（15%）存在胰岛细胞抗体；正常人群中的患病率为0.5%。HbA1浓度升高的20例患者中有5例（25%）胰岛细胞抗体呈阳性，而糖耐量正常的26例患者中有2例（8%）呈阳性。7例胰岛细胞抗体呈阳性的患者中有6例（86%）具有HLA - DR3或HLA - DR4抗原。未发现普遍的自身抗体产生。胰岛细胞抗体可能在一些囊性纤维化患者糖耐量异常的发生中起作用，这些患者因遗传易感性而产生抗体，作为对受损胰腺组织免疫反应的一部分。
