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用 ELISA 试验检测抗 GAD 和抗 IA2 自身抗体在一系列摩洛哥 1 型糖尿病儿科患者中的研究。

Research of anti-GAD and anti-IA2 autoantibodies by ELISA test in a series of Moroccan pediatric patients with diabetes type 1.

机构信息

Pediatric Endocrinology Unit, Hospital d'Enfant Abderrahim Harouchi Chu Ibn Rochd, Casablanca, Morocco.

Laboratory of Clinical Immunology, Allergy, and Inflammation LICIA, Faculty of Medicine and Pharmacy Hassan II University-Casablanca, Morocco.

出版信息

Afr Health Sci. 2020 Sep;20(3):1337-1343. doi: 10.4314/ahs.v20i3.40.

Abstract

INTRODUCTION

Type I diabetes (T1D) is an autoimmune disease with a prediabetic, asymptomatic period characterized by the selective destruction of insulin-producing β cells. During the pre-clinical phase, various auto-antibodies are generated against several beta cell antigens such as anti glutamate acid decarboxylase (Anti-GAD), anti tyrosine phosphatase (Anti-IA2). Today, the coupled detection of Anti-IA2 with that of Anti-GAD proves its great importance in the diagnosis and prediction of type 1 diabetes. The combined positivity for both antibodies has a specificity and a positive predictive value of 100%.

OBJECTIVES

In this work, we evaluate the diagnostic value of anti-GAD and anti-IA2 antibodies in a series based on 78 Moroccan subjects initially under 16, suspected T1D.

RESULTS AND DISCUSSION

Our series consists mainly of 74% of newly diagnosed patients for T1D and 26% of confirmed diagnostic patients, of whom 52% are females. The mean age of diagnosis is 7 ± 4 years, the mean of HbA1c at the time of diagnosis is 11.63 ± 2.16%, and the percentage of family history in our series is 69%. The proportion of positive results for anti-IA2 antibodies and anti-GAD antibodies are, respectively, 76.92% and 62.82%, and 52.56% of patients are positive for both auto-antibodies. This study confirms that anti-GAD and anti-IA2 auto-antibodies assays can detect patients early and the autoantibodies can persist several years after diagnosis of type 1 diabetes.

CONCLUSION

This study confirmed the diagnosis and classification of T1D (type 1A) in 87.18% of patients, and we reported that the prevalence of anti-GAD and anti-IA2 is higher in girls than in boys.

摘要

简介

1 型糖尿病(T1D)是一种自身免疫性疾病,有一个糖尿病前期、无症状的阶段,其特征是胰岛素产生β细胞的选择性破坏。在临床前阶段,会针对多种β细胞抗原产生各种自身抗体,如谷氨酸脱羧酶抗体(Anti-GAD)、酪氨酸磷酸酶抗体(Anti-IA2)等。如今,Anti-IA2 与 Anti-GAD 的联合检测在 1 型糖尿病的诊断和预测中具有重要意义。两种抗体的联合阳性具有 100%的特异性和阳性预测值。

目的

在这项工作中,我们评估了抗 GAD 和抗 IA2 抗体在 78 名最初年龄在 16 岁以下的摩洛哥疑似 1 型糖尿病患者系列中的诊断价值。

结果与讨论

我们的系列主要由 74%的新诊断为 1 型糖尿病患者和 26%的确诊诊断患者组成,其中 52%为女性。诊断时的平均年龄为 7 ± 4 岁,诊断时的平均 HbA1c 为 11.63 ± 2.16%,我们系列中的家族史比例为 69%。抗 IA2 抗体和抗 GAD 抗体的阳性结果比例分别为 76.92%和 62.82%,52.56%的患者两种自身抗体均为阳性。本研究证实,抗 GAD 和抗 IA2 自身抗体检测可早期检测到患者,且自身抗体在 1 型糖尿病诊断后可持续数年。

结论

本研究证实了 87.18%患者的 T1D(1 型 A)诊断和分类,我们报告说,女孩中抗 GAD 和抗 IA2 的患病率高于男孩。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fefe/7751543/252f9b7aebdf/AFHS2003-1337Fig1.jpg

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