Damm P, Kühl C, Buschard K, Jakobsen B K, Svejgaard A, Sodoyez-Goffaux F, Shattock M, Bottazzo G F, Mølsted-Pedersen L
Department of Obstetrics and Gynaecology, Rigshospitalet, University of Copenhagen, Denmark.
Diabet Med. 1994 Jul;11(6):558-63. doi: 10.1111/j.1464-5491.1994.tb02035.x.
The objective of the present study was to investigate the predictive value of islet cell antibodies (ICA) and insulin autoantibodies (IAA) for development of diabetes in women with previous gestational diabetes (GDM). Two hundred and forty-one previous diet-treated GDM patients and 57 women without previous GDM were examined 2-11 years after the index pregnancy. In subgroups, plasma from the diagnostic OGTT during index pregnancy was analysed for ICA and IAA. Among the previous GDM patients, 3.7% had developed Type 1 diabetes and 13.7% Type 2 diabetes. Four (2.9%) of the 139 GDM patients tested for ICA were ICA-positive and three of these had Type 1 diabetes at follow-up, as well as three ICA-negative patients. The sensitivity, specificity, and predictive value of ICA-positivity for later development of diabetes were 50%, 99%, and 75%, respectively. None of the women was IAA-positive during pregnancy. In conclusion, the majority of the patients with GDM did not show evidence of ongoing autoimmune destruction of the beta cells during the index pregnancy. However, ICA-positive GDM patients had a high risk of developing Type 1 diabetes later in life.
本研究的目的是调查胰岛细胞抗体（ICA）和胰岛素自身抗体（IAA）对既往患有妊娠期糖尿病（GDM）的女性发生糖尿病的预测价值。在本次妊娠后的2至11年，对241名既往接受饮食治疗的GDM患者和57名无既往GDM病史的女性进行了检查。在亚组中，分析了妊娠期间诊断性口服葡萄糖耐量试验（OGTT）的血浆中的ICA和IAA。在既往GDM患者中，3.7%发生了1型糖尿病，13.7%发生了2型糖尿病。在139名接受ICA检测的GDM患者中，4名（2.9%）ICA呈阳性，其中3名在随访时患有1型糖尿病，另外3名ICA阴性患者也患有1型糖尿病。ICA阳性对后期糖尿病发生的敏感性、特异性和预测价值分别为50%、99%和75%。在妊娠期间，没有女性IAA呈阳性。总之，大多数GDM患者在本次妊娠期间没有显示出β细胞持续发生自身免疫性破坏的证据。然而，ICA阳性的GDM患者在以后的生活中发生1型糖尿病的风险很高。
