Emergence of anti-islet autoantibodies in Japanese patients with type 1 diabetes
Emergence of anti-islet autoantibodies in Japanese patients with type 1 diabetes
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DOI：
10.1507/endocrj.k10e-068
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发表时间：
2010-07-01
影响因子：
2
通讯作者：
Eguchi, Katsumi
中科院分区：
文献类型：
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作者：
Horie, Ichiro;Kawasaki, Eiji;Eguchi, Katsumi
血清中的循环抗胰岛自身抗体被用作 1 型糖尿病 (T1D) 的预测标志物。我们在这里报告了两名患有自身免疫性甲状腺疾病并发 T1D 的日本患者，他们在糖尿病临床发病前观察了抗胰岛自身抗体的时间进程。案例1：一名25岁时患上格雷夫斯病的女性，31岁时被诊断出患有2型糖尿病；六个月后，开始胰岛素治疗。 36 岁时，由于谷氨酸脱羧酶 65 自身抗体 (GAD65Ab) 呈阳性且 C 肽水平降低，她被诊断患有 T1D。利用储存的血清，我们回顾性地追踪了她的抗胰岛自身抗体。 25岁时，GAD65Ab、锌转运蛋白8自身抗体（ZnT8Ab）和胰岛素自身抗体（IAA）被发现呈阳性。IAA很快转为阴性，但GAD65Ab和ZnT8Ab仍然呈高水平阳性。胰岛素瘤相关抗原 2 自身抗体 (IA-2Ab) 在胰岛素治疗开始前 2 年出现。她具有 T I D 易感 FILA-DRBI-DQB1 单倍型，*0405-*0401/*0802-*0302。病例2：一名49岁女性，因19年萎缩性甲状腺炎病史而患有甲状腺功能减退症，出现明显口渴、多尿和体重减轻。入院时，由于 GAD65Ab 阳性且 C 肽对静脉注射反应不佳，她被诊断为 T1D。胰高血糖素。回顾性血清学检查显示，临床发病后不久就出现了 GAD65Ab 和 IAA。 IA-2Ab 和 ZnT8Ab 从未发育。她具有 T1D 易感和耐药 HLA-DRB1-DQB1 单倍型，*0901-*0303/*1502-*0601。两个病例的自身抗体谱和糖尿病发病模式显着不同。这些病例表明抗胰岛自身抗体并不总是先于 1 型糖尿病发病。
Circulating anti-islet autoantibodies in sera are used as a predictive marker for type 1 diabetes (T1D). We here report two Japanese patients with autoimmune thyroid disease complicated with T1D in whom the time course of anti-islet autoantibodies were observed before the clinical onset of diabetes. Case 1: A woman who had developed Graves' disease at age 25 was diagnosed with type 2 diabetes at age 31; six months later, insulin therapy was started. At age 36 she was diagnosed with T1D due to glutamic acid decarboxylase 65 autoantibodies (GAD65Ab)-positive status and decreased C-peptide levels. With stored sera we retrospectively followed her anti-islet autoantibodies. GAD65Ab, zinc transporter 8 autoantibodies (ZnT8Ab) and insulin autoantibodies (IAA) were found to be positive at age 25. IAA soon turned negative, but GAD65Ab and ZnT8Ab remained positive with high levels. Insulinoma-associated antigen-2 autoantibodies (IA-2Ab) emerged 2 years before the initiation of insulin therapy. She has T I D-susceptible FILA-DRBI-DQB1 haplotypes, *0405-*0401/*0802-*0302. Case 2: A 49-year-old woman with hypothyroidism due to 19 years' history of atrophic thyroiditis noticed marked thirst, polyuria and weight loss. On admission she was diagnosed as T1D due to GAD65Ab-positive findings and poor C-peptide response to i.v. glucagon. Retrospective serology revealed the emergence of GAD65Ab and IAA just after the clinical onset. IA-2Ab and ZnT8Ab never developed. She has T1D-suseeptible and -resistant HLA-DRB1-DQB1 haplotypes, *0901-*0303/*1502-*0601. The autoantibody profile and the mode of diabetes onset in the two cases were remarkably different. These cases imply that anti-islet autoantibodics do not always precede the onset of T1D.