Humphrey A R, McCarty D J, Mackay I R, Rowley M J, Dwyer T, Zimmet P
Redbridge and Waltham Forest Health Authority, Essex, UK.
Diabet Med. 1998 Feb;15(2):113-9. doi: 10.1002/(SICI)1096-9136(199802)15:2<113::AID-DIA528>3.0.CO;2-D.
We investigated the association of serum antibodies to glutamic acid decarboxylase (GADab) with early start of insulin treatment (< or = 1 year from diagnosis, or < or = 2 years from diagnosis) using data from a representative sample of 374 adult-onset insulin-treated individuals from the Tasmanian Diabetes Register. Furthermore, we examined whether this association was stronger than the phenotypic characteristics (age at diagnosis, sex, family history of diabetes, level of obesity, duration of diabetes) often used for diabetes classification. In this cohort, 35.9% of males and 38.5% of females were GADab positive. Within the first year from diagnosis, 78.4% of GADab positive people compared to 44.0% of GADab negative people (p < 0.001) had started insulin treatment. Univariate associations with insulin treatment < or = 1 year from diagnosis included GADab positivity, no family history of diabetes, lower BMI for men, and GADab positivity and lower BMI for women. In multivariate models, significant associations with insulin treatment < or = 1 year from diagnosis included a family history of diabetes (OR = 0.47, 95% CI = 0.23-0.95) and GADab positivity (OR = 2.19, 95% CI = 1.01-4.73) for men, but only GADab positivity (OR = 7.53, 95% CI = 3.09-18.30) for women. Age at diagnosis was not associated with insulin treatment < or = 1 year or < or = 2 years from diagnosis for either sex. These findings indicate that a positive GADab test result is strongly associated with start of insulin treatment within 1 or 2 years from diagnosis, more so than characteristics such as level of obesity and age at diagnosis.
我们利用塔斯马尼亚糖尿病登记处374例成年起病胰岛素治疗患者的代表性样本数据，研究了谷氨酸脱羧酶血清抗体（GADab）与胰岛素治疗早期开始（诊断后≤1年，或诊断后≤2年）之间的关联。此外，我们还研究了这种关联是否比常用于糖尿病分类的表型特征（诊断时年龄、性别、糖尿病家族史、肥胖程度、糖尿病病程）更强。在这个队列中，35.9%的男性和38.5%的女性GADab呈阳性。在诊断后的第一年内，78.4%的GADab阳性患者开始了胰岛素治疗，而GADab阴性患者的这一比例为44.0%（p < 0.001）。与诊断后≤1年胰岛素治疗的单因素关联包括GADab阳性、无糖尿病家族史、男性较低的体重指数，以及女性的GADab阳性和较低的体重指数。在多变量模型中，与诊断后≤1年胰岛素治疗的显著关联包括男性的糖尿病家族史（OR = 0.47，95% CI = 0.23 - 0.95）和GADab阳性（OR = 2.19，95% CI = 1.01 - 4.73），但女性仅为GADab阳性（OR = 7.53，95% CI = 3.09 - 18.30）。诊断时年龄与男女诊断后≤1年或≤2年的胰岛素治疗均无关联。这些发现表明，GADab检测结果呈阳性与诊断后1年或2年内开始胰岛素治疗密切相关，比肥胖程度和诊断时年龄等特征更为密切。
