Relation Between Insulin Antibody and Complement-Fixing Islet Cell Antibody at Clinical Diagnosis of IDDM
Relation Between Insulin Antibody and Complement-Fixing Islet Cell Antibody at Clinical Diagnosis of IDDM
复制标题
胰岛素抗体与补体固定胰岛细胞抗体在IDDM临床诊断中的关系
作者：
J. Karjalainen;M. Knip;A. Mustonen;J. Ilonen;H. Akerblom
为了验证胰岛素治疗前循环中出现的胰岛素结合抗体（IBAs）是β细胞损伤的标志物这一假设，我们研究了60例平均年龄为9.5岁的新诊断糖尿病儿童中IBAs以及常规（IF-ICA）和补体（CF-ICA）固定胞浆胰岛细胞抗体的患病率。17例（28.3%）的胰岛素结合率超过68例年龄匹配对照组的上限（2.8%）。IBA阳性受试者的特点是发病年龄较轻[6.2 ± 4.0（SD）vs. 10.8 ± 3.2岁; P < 0.001]，糖化血红蛋白A水平较低，（14.1 ± 3.1 vs. 16.0 ± 3.0%; P < 0.05），血清C肽浓度降低（0.12 ± 0.07 vs.0.20 ± 0.17nmol/L; P < 0.05），HLA-Dw 4频率增高（9/13 vs.11/37; P < 0.05）。多元回归分析显示，年龄调整后IBAs与血清C肽浓度无显著相关性。43名儿童（75%）IF-ICA呈阳性，38名儿童（63.3%）CF-ICA呈阳性。12例IBA阳性的糖尿病患者（70.6%）血清中有IFICA和CF-ICA。然而，IBA与IF-ICA或CF-ICA之间未观察到相关性。结果表明，诊断前IBAs的发展作为一个指标的临床和遗传异质性的胰岛素依赖型糖尿病，而不是作为自身免疫性β细胞破坏的标志。
To test the hypothesis that insulin-binding antibodies (IBAs) appearing in the circulation before insulin treatment are markers of β-cell damage, we studied the prevalence of IBAs and both conventional (IF-ICAs)- and complement (CF-ICAs)-fixing cytoplasmic islet cell antibodies in 60 newly diagnosed diabetic children with a mean age of 9.5 yr. Seventeen (28.3%) had an insulin binding exceeding the upper range (2.8%) of that observed in 68 age-matched controls. The IBA-positive subjects were characterized by a younger age of onset [6.2 ± 4.0 (SD) vs. 10.8 ± 3.2 yr; P < 0.001], lower glycosylated hemoglobin A, levels (14.1 ± 3.1 vs. 16.0 ± 3.0%; P < 0.05), lower serum C-peptide concentrations (0.12 ± 0.07 vs. 0.20 ± 0.17 nmol/L; P < 0.05), and an increased frequency of HLA-Dw4 (9/13 vs. 11/37; P < 0.05). There was no significant relation between IBAs and serum C-peptide concentrations after age adjustment by multiple regression analysis. Forty-three children (75%) were positive for IF-ICA and 38 (63.3%) for CF-ICA. Twelve IBA-positive diabetics (70.6%) had IFICA as well as CF-ICA in their serum. No association could be observed between IBA and either IF-ICA or CF-ICA, however. The results suggest that IBAs developing before diagnosis serve as an indicator of clinical and genetic heterogeneity within IDDM rather than as a marker of autoimmune β-cell destruction.
胰岛素依赖性糖尿病相关 HLA-D 区域编码的决定簇。
影响因子：
2.7
作者：
Bach,FH;Rich,SS;Barbosa,J;Segall,M
通讯作者：
Segall,M
影响因子：
56.9
作者：
PALMER, JP;ASPLIN, CM;PAQUETTE, TL
通讯作者：
PAQUETTE, TL