Verge C F, Howard N J, Rowley M J, Mackay I R, Zimmet P Z, Egan M, Hulinska H, Hulinsky I, Silvestrini R A, Kamath S
Ray Williams Institute for Paediatric Endocrinology, Royal Alexandra Hospital for Children, Sydney, Australia.
Diabetologia. 1994 Nov;37(11):1113-20. doi: 10.1007/BF00418375.
Sera obtained at diagnosis from 273 children (0-14 years) with insulin-dependent diabetes mellitus (IDDM) were studied to compare different autoantibody levels. The subjects comprise 75% of all incident cases in New South Wales, Australia, for a 2-year period (ascertainment > 99% complete). Antibodies against glutamate decarboxylase were measured by radioimmunoprecipitation, insulin autoantibodies (on 176 sera collected within 4 days of initiation of insulin therapy) by radioimmunoassay, thyroid peroxidase and antigliadin IgA antibodies by enzyme-linked immunoassay, and anti-endomysial IgA and islet cell antibodies by indirect immunofluorescence. Reference ranges for anti-glutamate decarboxylase and insulin autoantibodies were determined in a group of non-diabetic children. Of the sera 69% were positive for anti-glutamate decarboxylase, 65% for insulin autoantibodies, 71% for islet cell antibodies (> or = 20 Juvenile Diabetes Foundation units), 10% for anti-thyroid peroxidase, 2.6% for antigliadin and 3.0% for anti-endomysial antibodies. Islet cell antibodies and insulin autoantibodies were both negative in 13.7% of the sera, while only 5.8% were negative for all three of islet cell antibodies, insulin autoantibodies and anti-glutamate decarboxylase. There was a higher frequency of anti-glutamate decarboxylase among girls than boys (75% vs 63%, p = 0.03) and a negative correlation between the level of insulin autoantibodies and age at diagnosis (r = -0.41, p < 0.0001). A higher frequency of antithyroid peroxidase was found with increasing age (p = 0.05). Higher titres of islet cell antibodies were associated with a higher frequency of both anti-glutamate decarboxylase (p < 0.0001) and insulin autoantibodies (p = 0.003).(ABSTRACT TRUNCATED AT 250 WORDS)
对273名0至14岁胰岛素依赖型糖尿病（IDDM）儿童在诊断时采集的血清进行研究，以比较不同自身抗体水平。这些受试者占澳大利亚新南威尔士州两年内所有新发病例的75%（确诊率>99%）。通过放射免疫沉淀法检测抗谷氨酸脱羧酶抗体，通过放射免疫分析法检测胰岛素自身抗体（对胰岛素治疗开始后4天内采集的176份血清），通过酶联免疫吸附测定法检测甲状腺过氧化物酶和抗麦醇溶蛋白IgA抗体，通过间接免疫荧光法检测抗肌内膜IgA和胰岛细胞抗体。在一组非糖尿病儿童中确定了抗谷氨酸脱羧酶和胰岛素自身抗体的参考范围。69%的血清抗谷氨酸脱羧酶呈阳性，65%的血清胰岛素自身抗体呈阳性，71%的血清胰岛细胞抗体呈阳性（≥20青少年糖尿病基金会单位），10%的血清抗甲状腺过氧化物酶呈阳性，2.6%的血清抗麦醇溶蛋白呈阳性，3.0%的血清抗肌内膜抗体呈阳性。13.7%的血清胰岛细胞抗体和胰岛素自身抗体均为阴性，而胰岛细胞抗体、胰岛素自身抗体和抗谷氨酸脱羧酶全部阴性的血清仅占5.8%。女孩中抗谷氨酸脱羧酶的频率高于男孩（75%对63%，p = 0.03），胰岛素自身抗体水平与诊断时的年龄呈负相关（r = -0.41，p < 0.0001）。随着年龄增长，抗甲状腺过氧化物酶的频率更高（p = 0.05）。更高滴度的胰岛细胞抗体与抗谷氨酸脱羧酶（p < 0.0001）和胰岛素自身抗体（p = 0.003）的更高频率相关。（摘要截短至250字）
