EPIDEMIOLOGY OF ISLET CELL AUTOIMMUNITY IN NIDDM

描述：有几条证据表明2型 (非胰岛素依赖型)糖尿病是一种异质性疾病， 结果是胰岛素分泌异常和 胰岛素的作用。2型糖尿病患者胰岛素分泌减少的原因探讨 仍未完全了解，但在2型糖尿病的一个亚群中 患者可能与胰腺自身免疫性破坏有关 β细胞。急性时相反应的明显激活，这被发现 在初步研究中与胰岛细胞自身免疫有关，可能 在一定程度上解释了2型糖尿病患者胰岛素分泌缺陷。那里 一直没有进行广泛的调查，特别是在美国，关于 胰岛细胞自身免疫的患病率及其临床意义 尤其是老年2型糖尿病患者。两个最广泛的 用于诊断和预测自身免疫性糖尿病的标志物，即 GAD65和IA-2自身抗体以及活化的炎症标志物 急性期反应将在一个特征良好的人群中应用 来自心血管健康中心的65岁以上2型糖尿病患者 研究(CHS)。社区卫生服务是一项纵向研究，旨在确定 并评估糖尿病等与发病率和死亡率相关的因素 年冠心病和卒中的自然病史 65岁及以上的非住院成年人。身份的鉴定 公众中有患自身免疫性2型糖尿病风险的个人 健康利益，因为免疫调节策略可能是 及早开始，以预防与高血糖相关的并发症 可能还有开始需要胰岛素的时间。一个更合适的 自身免疫性2型糖尿病患者亚群的特征 发病机制将有利于今后对自然病因学的研究。 2型糖尿病的病史和治疗。

DESCRIPTION: Several lines of evidence indicate that Type 2 (non-insulin-dependent) diabetes mellitus is a heterogeneous disease that results from a combination of abnormalities in both insulin secretion and insulin action. The causes of decreased insulin secretion in Type 2 diabetes are still not completely understood, but in a subgroup of Type 2 diabetic patients they may be related to an autoimmune destruction of the pancreatic beta cells. A pronounced activation of the acute-phase response, that was found to be associated with islet cell autoimmunity in the Preliminary Studies, may in part explain the defect in insulin secretion seen in Type 2 diabetes. There have been no extensive investigations, particularly in the U.S., with regard to the prevalence and clinical significance of islet cell autoimmunity particularly in elderly patients with Type 2 diabetes. Two of the most widely used markers for the diagnosis and prediction of autoimmune diabetes, namely GAD65 and IA-2 autoantibodies, along with inflammatory markers of activation of the acute phase response, will be applied in a well-characterized population of Type 2 diabetic patients over the age of 65 from the Cardiovascular Health Study (CHS). The CHS is a longitudinal study, which was proposed to identify and evaluate factors, such as diabetes mellitus, related to the incidence and the natural history of Coronary Heart Disease (CHD) and stroke in non-institutionalized adults 65 years and older. The identification of individuals at risk of developing autoimmune Type 2 diabetes is of public health interest because immunomodulatory strategies could potentially be instituted early enough to prevent the complications related with hyperglycemia and, possibly, the time of onset of insulin requirement. A more appropriate characterization of a subgroup of Type 2 diabetic patients of autoimmune pathogenesis will be of benefit to future research into the etiology, natural history as well as treatment of Type 2 diabetes mellitus.