The Prevalence of Islet Cell Antibodies in Japanese Insulin-dependent and Non-insulin-dependent Diabetic Patients Studied by Indirect Immunofluorescence and by a New Method
The Prevalence of Islet Cell Antibodies in Japanese Insulin-dependent and Non-insulin-dependent Diabetic Patients Studied by Indirect Immunofluorescence and by a New Method
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通过间接免疫荧光和新方法研究日本胰岛素依赖型和非胰岛素依赖型糖尿病患者中胰岛细胞抗体的流行率
作者：
Tetsuro Kobayashi;T. Sugimoto;T. Itoh;K. Kosáka;Toshiaki Tanaka;S. Suwa;Kaoru Sato;Kimiyoshi Tsuji
采用标准的间接免疫荧光法（IF法）和新建立的应用生物素-亲和素系统的三层免疫荧光法（BAS法）测定了日本胰岛素依赖型糖尿病（IDDM）和非胰岛素依赖型糖尿病（NIDDM）患者的胰岛细胞抗体（伊卡）。此外，本文还研究了胰岛素依赖型糖尿病患者伊卡与HLA的关系。BAS法与IF法测定的伊卡效价相关性良好（rs = 0.987，P < 0.01）。BAS方法对伊卡的灵敏度比IF方法高约8倍。BAS法与IF法检测伊卡的总患病率在IDDM患者中分别为41%（82/198）与28%（56/198），在NIDDM患者中分别为3%（19/593）与2%（14/593）。在IDDM患者中，ICA-BAS在发病后1个月内全部阳性，而ICA-IF在发病后1个月内的阳性率为83%（20/24）。ICA-IF的患病率随病程的延长而迅速下降，病程10年以上的ICA-IF患病率为6%（3/55）。ICA-BAS的发病率也随着疾病的持续时间而下降，尽管程度低于ICA-IF。HLA分型与ICA-BAS或-IF的持续性无相关性。这些结果表明，胰腺自身免疫过程发生在几乎所有的日本IDDM患者。虽然在日本，胰岛素依赖型糖尿病的发病率低于高加索人，但伊卡的发病率似乎是相同的。BAS方法的较高灵敏度可能具有重要的诊断价值，特别是在病程较长的患者中。
Islet cell antibodies (ICA) were measured in Japanese patients with insulin-dependent diabetes mellitus (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM) by a standard, indirect immunofluorescence method (IF method) and by a newly established, threelayer immunofluorescence method applying a biotin-avidin system (BAS method). In addition, the relationship between ICA and HLA was studied in IDDM patients. ICA titers detected by the BAS method correlated well with those determined by the standard IF method (rs = 0.987, P < 0.01). The BAS method had about an eightfold higher sensitivity for ICA than the IF method. The overall prevalence of ICA detected by the BAS method (ICA-BAS) versus that by the IF method (ICAIF) was 41% (82/198) versus 28% (56/198) in IDDM patients and 3% (19/593) versus 2% (14/593) in patients with NIDDM. In IDDM patients, ICA-BAS was all positive <1 mo after the onset of diabetes, while the prevalence of ICA-IF was 83% (20/24) during the same period. The prevalence of ICA-IF decreased rapidly with the duration of disease, reaching a value of 6% (3/55) in the patients with a disease duration of 10 yr or more. The incidence of ICA-BAS also decreased with the duration of disease, although to a lesser degree than ICA-IF. No association was found between HLA types and persistence of ICA-BAS or -IF. These results suggest that pancreatic autoimmune processes occur in almost all Japanese IDDM patients. Although IDDM is less common in Japan than among Caucasians, the prevalence of ICA seems to be the same. The higher sensitivity of the BAS method may be of significant diagnostic value, especially in patients with a long duration of disease.