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非糖尿病 COVID-19 患者胰腺 β 细胞自身抗体的评估。

The evaluation of pancreas β-cell autoantibodies in non-diabetic COVID-19 patients.

机构信息

Department of Internal Medicine, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey,

Department of Endocrinology and Metabolism, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.

出版信息

Arch Endocrinol Metab. 2022;66(4):459-465. doi: 10.20945/2359-3997000000498. Epub 2022 Jun 2.

Abstract

OBJECTIVE

This study aims to evaluate potential pancreas endocrine damage due to SARS-CoV-2 by measuring β-cell autoantibodies in COVID-19 patients.

SUBJECTS AND METHODS

Between June and July 2020, 95 inpatients with a positive COVID-19 test result after polymerase-chain-reaction (PCR) and who met the inclusion criteria were enrolled in our study. Laboratory parameters that belong to glucose metabolism and β-cell autoantibodies, including anti-islet, anti-glutamic acid decarboxylase, and anti-insulin autoantibodies, were measured. β-cell autoantibodies levels of the patients were measured during COVID-19 diagnosis. Positive results were reevaluated in the 3rd month of control.

RESULTS

In the initial evaluation, 4 (4.2%) patients were positive for anti-islet autoantibody. Only one (1.1%) patient was positive for anti-glutamic acid decarboxylase autoantibody. No patient had positive results for anti-insulin autoantibody. FPG, HbA1c, and C-peptide levels were similar in patients who were split into groups regarding the initial positive or negative status of anti-islet and anti-GAD autoantibodies (p>0.05). In the 3rd month after the initial measurements, anti-islet autoantibody positivity of 2 (50%) of 4 patients and anti-glutamic acid decarboxylase positivity of 1 (100%) patient were persistent. Finally, 3 (3.1%) patients in the whole group were positive for anti-islet autoantibody in the 3rd month of control. No difference was determined between the initial and the 3rd month of parameters of glucose metabolism.

CONCLUSION

Following an ongoing autoantibody positivity in the present study brings the mind that SARS-CoV-2 may be responsible for the diabetogenic effect. Clinicians should be aware of autoantibody-positive DM as a potential autoimmune complication in patients with SARS-CoV-2.

摘要

目的

通过测量 COVID-19 患者的β细胞自身抗体来评估 SARS-CoV-2 引起的潜在胰腺内分泌损伤。

对象与方法

2020 年 6 月至 7 月,我们对经聚合酶链反应(PCR)检测呈阳性且符合纳入标准的 95 名 COVID-19 住院患者进行了研究。测量了属于葡萄糖代谢和β细胞自身抗体的实验室参数,包括胰岛自身抗体、谷氨酸脱羧酶自身抗体和胰岛素自身抗体。在 COVID-19 诊断时测量了患者的β细胞自身抗体水平。在第 3 个月的对照时复查阳性结果。

结果

在初始评估中,4(4.2%)例患者胰岛自身抗体阳性。只有 1(1.1%)例患者谷氨酸脱羧酶自身抗体阳性。没有患者胰岛素自身抗体阳性。根据胰岛和谷氨酸脱羧酶自身抗体初始阳性或阴性状态将患者分组,FPG、HbA1c 和 C 肽水平无差异(p>0.05)。在初始测量后的第 3 个月,4 例患者中有 2 例(50%)胰岛自身抗体阳性,1 例(100%)谷氨酸脱羧酶阳性持续存在。最后,在整个研究组中,有 3(3.1%)例患者在第 3 个月的对照时胰岛自身抗体阳性。葡萄糖代谢参数在初始和第 3 个月之间没有差异。

结论

本研究中持续存在的自身抗体阳性提示 SARS-CoV-2 可能与致糖尿病作用有关。临床医生应注意 COVID-19 患者自身抗体阳性 DM 作为潜在的自身免疫并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5173/10697637/ab59c929124b/2359-4292-aem-66-04-0459-gf01.jpg

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