Martinka E, Straková J, Ocenásová A, Pullmannová D, Petrisková J, Mácková N, Sutarík L, Galajda P, Baláz D, Kerný J, Vladár L, Mokán M
I. interná klinika, JLF UK a MFN, Martin.
Vnitr Lek. 1998 Jan;44(1):17-22.
To assess the prevalence of markers of autoimmune destruction of pancreatic beta-cells in patients with non-insulin dependent diabetes mellitus (NIDDM).
127 hospitalized NIDDM patients subdivided to the following subgroups: non-obese with C-peptide < 0.3 nmol/l (NIDDM-(-)), non-obese with C-peptide > 0.3 nmol/l (NIDDM-(+)), obese with C-peptide < 0.3 nmol/l (NIDDM+(-)) and obese with C-peptide > 0.3 nmol/l (NIDDM2+). METHODS AND MEASURED PARAMETERS: Age, BMI, C-peptide, autoantibodies to glutamic acid decarboxylase (antiGAD-Ab), autoantibodies to islet cells (ICA), markers of specific cellular immunity CD4, CD8, CD19, CD4/CD8, CD4/CD45/RA+, CD4/CD45/RA-, NK (CD16+56), CD3/HLADR, organ specific/non-specific autoantibodies.
AntiGAD-Ab were positive in 5/15 (33.3%) NIDDM-(-), 1/32 (3.1%) NIDDM-(+), 2/9 (22.2%) NIDDM+(-) and in 3/71 (4.2%) NIDDM2+. The positivity of antiGAD-Ab in NIDDM-(-) and NIDDM+(-) was significantly higher (p < 0.05) than in NIDDM-(+) and NIDDM2+.
Some patients with manifestation of diabetes in older age initially classified and treated as having NIDDM may have in fact slowly evolving autoimmune insulin-dependent diabetes mellitus (LADA). These patients can be identified by measurement of antiGAD-Ab or other markers (ICA, IA-2) of autoimmune destruction of pancreatic beta-cells (AID). Moreover, in some patients both AID and insulin resistance may coexist in parallel.
评估非胰岛素依赖型糖尿病（NIDDM）患者胰腺β细胞自身免疫性破坏标志物的患病率。
127例住院的NIDDM患者，分为以下亚组：C肽<0.3 nmol/l的非肥胖患者（NIDDM-(-)）、C肽>0.3 nmol/l的非肥胖患者（NIDDM-(+)）、C肽<0.3 nmol/l的肥胖患者（NIDDM+(-)）和C肽>0.3 nmol/l的肥胖患者（NIDDM2+）。方法和测量参数：年龄、体重指数、C肽、谷氨酸脱羧酶自身抗体（抗GAD-Ab）、胰岛细胞自身抗体（ICA）、特异性细胞免疫标志物CD4、CD8、CD19、CD4/CD8、CD4/CD45/RA+、CD4/CD45/RA-、自然杀伤细胞（CD16+56）、CD3/HLADR、器官特异性/非特异性自身抗体。
抗GAD-Ab在5/15（33.3%）的NIDDM-(-)患者、1/32（3.1%）的NIDDM-(+)患者、2/9（22.2%）的NIDDM+(-)患者和3/71（4.2%）的NIDDM2+患者中呈阳性。NIDDM-(-)和NIDDM+(-)患者中抗GAD-Ab的阳性率显著高于（p<0.05）NIDDM-(+)和NIDDM2+患者。
一些老年糖尿病表现患者最初被分类并当作NIDDM进行治疗，实际上可能患有缓慢进展的自身免疫性胰岛素依赖型糖尿病（LADA）。这些患者可通过检测抗GAD-Ab或胰腺β细胞自身免疫性破坏（AID）的其他标志物（ICA、IA-2）来识别。此外，在一些患者中AID和胰岛素抵抗可能同时并存。
