Department of Endocrinology and Metabolism, Tokyo Metropolitan Health and Hospitals Corporation Okubo Hospital, 2-44-1 Kabuki-Cho, Shinjyuku-Ku, Tokyo, 160-8488, Japan.
Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
BMC Endocr Disord. 2023 Jan 6;23(1):5. doi: 10.1186/s12902-023-01263-z.
The coronavirus disease 2019 (COVID-19) pandemic has dramatically impacted global health, and patients with type 2 diabetes have been identified as a high-risk group for COVID-19 infection and the development of severe disease. In response, this study aimed to evaluate whether patients with type 2 diabetes infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) could develop antibody responses in the same manner as patients without diabetes, and whether there is a difference in antibody response to SARS-CoV-2 between patients with diabetes diagnosed prior to hospitalization, and those with newly diagnosed diabetes.
SARS-CoV-2-specific immunoglobulin G (IgG) levels were quantified using two iFlash 3000 Chemiluminescence Immunoassay analyzer kits (Shenzhen YHLO Biotech Co., Ltd.) to detect IgG antibodies specific for nucleocapsid protein (IgG-N), and specific for the S1 subunit of the spike protein (IgG-S1). In 124 hospitalized patients with COVID-19, 40 patients with type 2 diabetes were matched to 40 patients without diabetes using propensity score matching (PSM).
There was no difference in IgG-N and IgG-S1 levels between the patients with diabetes and those without. Of patients with diabetes, 31 patients had known diabetes and nine patients had newly diagnosed diabetes. The median levels of IgG-N at 7-13 days in patients with newly diagnosed diabetes were significantly lower than those in patients with known diabetes (IgG-N; 10.9 vs. 31.0 AU/mL, p = 0.031, IgG-S1; 7.5 vs. 24.4 AU/mL, p = 0.023).
Even after adjusting for covariates using PSM, COVID-19 patients with type 2 diabetes had comparable antibody responses to patients without diabetes. Patients with newly diagnosed diabetes had lower IgG-N and IgG-S1 production in the second week of the disease compared with those with previously known diabetes.
2019 年冠状病毒病（COVID-19）大流行对全球健康产生了巨大影响，已确定 2 型糖尿病患者是 COVID-19 感染和重症疾病发展的高危人群。有鉴于此，本研究旨在评估 2 型糖尿病患者感染严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）后是否能与非糖尿病患者一样产生抗体反应，以及糖尿病患者与新诊断糖尿病患者之间对 SARS-CoV-2 的抗体反应是否存在差异。
使用两台 iFlash 3000 化学发光免疫分析仪试剂盒（深圳亚辉龙生物科技股份有限公司）定量检测 SARS-CoV-2 特异性免疫球蛋白 G（IgG）水平，以检测针对核衣壳蛋白（IgG-N）和刺突蛋白 S1 亚单位（IgG-S1）的 IgG 抗体。在 124 例住院 COVID-19 患者中，采用倾向评分匹配（PSM）将 40 例 2 型糖尿病患者与 40 例非糖尿病患者相匹配。
糖尿病患者和非糖尿病患者的 IgG-N 和 IgG-S1 水平无差异。在糖尿病患者中，31 例为已知糖尿病，9 例为新诊断糖尿病。新诊断糖尿病患者在第 7-13 天 IgG-N 中位数水平明显低于已知糖尿病患者（IgG-N：10.9 与 31.0 AU/mL，p=0.031；IgG-S1：7.5 与 24.4 AU/mL，p=0.023）。
即使使用 PSM 调整协变量后，2 型糖尿病 COVID-19 患者的抗体反应与非糖尿病患者相当。与先前已知的糖尿病患者相比，新发糖尿病患者在疾病的第二周 IgG-N 和 IgG-S1 的产生较低。
