PREVALENCE AND PREDICTIVE VALUE OF ISLET-CELL ANTIBODIES AND INSULIN AUTOANTIBODIES IN WOMEN WITH GESTATIONAL DIABETES
PREVALENCE AND PREDICTIVE VALUE OF ISLET-CELL ANTIBODIES AND INSULIN AUTOANTIBODIES IN WOMEN WITH GESTATIONAL DIABETES
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DOI：
10.1111/j.1464-5491.1994.tb02035.x
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发表时间：
1994-07-01
影响因子：
3.5
通讯作者：
MOLSTEDPEDERSEN, L
中科院分区：
文献类型：
--
作者：
DAMM, P;KUHL, C;MOLSTEDPEDERSEN, L
本研究的目的是探讨胰岛细胞抗体（伊卡）和胰岛素自身抗体（IAA）的预测价值的发展糖尿病的妇女先前妊娠糖尿病（GDM）。241例既往饮食治疗的GDM患者和57例既往无GDM的女性在指数妊娠后2-11年进行了检查。在亚组中，对首次妊娠期间诊断性OGTT的血浆进行伊卡和IAA分析。在既往GDM患者中，3.7%发生1型糖尿病，13.7%发生2型糖尿病.在139例接受伊卡检测的GDM患者中，有4例（2.9%）为ICA阳性，其中3例在随访时患有1型糖尿病，还有3例ICA阴性患者。ICA阳性对糖尿病后期发展的敏感性、特异性和预测值分别为50%、99%和75%。这些妇女在怀孕期间没有一个是IAA阳性的。总之，大多数GDM患者在指数妊娠期间没有表现出持续自身免疫性β细胞破坏的证据。然而，ICA阳性的GDM患者在以后的生活中发展为1型糖尿病的风险很高。
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.