Clinical significance of the combined detection of GAD-Ab, IA2-Ab and ICA in patients with diabetes mellitus

doi:10.3969/j.issn.1673-8640.2015.05.014

Abstract

Abstract: Objective To investigate the clinical significance of the combined detection of anti-glutamic acid decarboxylase antibody(GAD-Ab), anti-protein tyrosine phosphatase antibody(IA2-Ab) and anti-islet cell antibody(ICA) in the diagnosis of diabetes mellitus. Methods A total of 136 patients with diabetes mellitus were enrolled, including 54 cases of type 1 diabetes mellitus and 82 cases of type 2 diabetes mellitus, and 65 healthy controls were enrolled as healthy control group. GAD-Ab and IA2-Ab were determined by enzyme-linked immunosorbent assay (ELISA), and ICA was determined by indirect immunofluorescence assay. Results The positive rates of ICA, GAD-Ab and IA2-Ab in patients with type 1 diabetes mellitus(22.2%, 61.1% and 11.1%) were significantly higher than those in patients with type 2 diabetes mellitus (2.4%, 4.9% and 1.2%) and control group (0%, 0% and 0%, P<0.05). The positive rate of GAD-Ab in patients with type 1 diabetes mellitus was higher than those of ICA and IA2-Ab(P<0.001). The sensitivity and diagnostic accordance rate of GAD-Ab were higher than those of ICA and IA2-Ab(P<0.05). The sensitivities and diagnostic accordance rates of the combined detections of GAD-Ab+ICA, GAD-Ab+IA2-Ab and ICA+GAD-Ab+IA2-Ab were also higher than those of ICA and IA2-Ab(P<0.05). Conclusions The combined detection of GAD-Ab, IA2-Ab and ICA has important significance in the diagnosis and classification of diabetes mellitus.

Key words: Anti-glutamic acid decarboxylase antibody, Anti-protein tyrosine phosphatase antibody, Anti-islet cell antibody, Diabetes mellitus

CLC Number:

R446.5

ZHOU Houqing, WU Xinggui. Clinical significance of the combined detection of GAD-Ab, IA2-Ab and ICA in patients with diabetes mellitus[J]. Laboratory Medicine, 2015, 30(5): 465-467.

Figures/Tables 2

References 9

[1]	熊东林,黄芬.糖尿病自身抗体的检测及临床意义[J].中国医药指南,2012,10(17):66-67.
[2]	丛玉隆,尹一兵,陈瑜.检验医学高级教程[M].北京:人民军医出版社,2010:627.
[3]	张利方,刘莹,石莉萍,等.胰岛抗体鉴别诊断自身免疫性糖尿病的临床意义[J].中国实验诊断学,2013,17(10):1880-1881.
[4]	黄莹,万里凯,陈莉红.联合检测血清GADA、ICA、IAA在糖尿病诊断和分型中的临床意义[J].右江民族医学院学报,2013,35(4):512-513.
[5]	马晓静,包玉倩,周健,等.血清谷氨酸脱羧酶抗体滴度与初诊成人2型糖尿病患者第一时相胰岛素分泌的关系[J].中华内分泌代谢杂志,2010,26(2):122-124.
[6]	刘锐,郑岚,何成彦,等.GADA、ICA和IAA联合检测对1型糖尿病的诊断价值[J].中国实验诊断学,2010,14(3):402-405.
[7]	许中,陈尔旦,吕国萍,等.糖尿病患者GAD-Ab和ICA测定及临床意义[J].上海医学检验杂志,2000,15(3):162.
[8]	TAKASHIMA S, NISHII N, HACHISU T,et al.Natural anti-insulin autoantibodies in cats: enzyme-linked immunosorbent assay for the determination of plasma anti-insulin IgG and its concentrations in domestic cats[J]. Res Vet Sci, 2013,95(3):886-890.
[9]	陈飞,王安才,陈月云,等.胰岛细胞自身抗体联合检测对成人糖尿病免疫学诊断的意义[J].安徽医学,2011,32(3):341-343.

组别	例数	ICA	GAD-Ab	IA2-Ab
1型糖尿病组	54	22.2^#	61.1	11.1^#
2型糖尿病组	82	2.4^*	4.9^*	1.2^*
正常对照组	65	0^*	0^*	0^*

组别	例数	ICA	GAD-Ab	IA2-Ab
1型糖尿病组	54	22.2^#	61.1	11.1^#
2型糖尿病组	82	2.4^*	4.9^*	1.2^*
正常对照组	65	0^*	0^*	0^*

组合方式	阳性例数	敏感性	阳性预报率	阴性预报率	诊断符合率
ICA	12	22.2	100	60.7	64.7
GAD-Ab	33	61.1^*#	100	75.6	82.4^*#
IA2-Ab	6	11.1	100	55.6	59.7
GAD-Ab+ICA	33	61.1^*#	100	75.6	82.4^*#
ICA+IA2-Ab	15	27.8	100	62.5	67.2
GAD-Ab+IA2-Ab	33	61.1^*#	100	75.6	82.4^*#
ICA+GAD-Ab+IA2-Ab	33	61.1^*#	100	75.6	82.4^*#

组合方式	阳性例数	敏感性	阳性预报率	阴性预报率	诊断符合率
ICA	12	22.2	100	60.7	64.7
GAD-Ab	33	61.1^*#	100	75.6	82.4^*#
IA2-Ab	6	11.1	100	55.6	59.7
GAD-Ab+ICA	33	61.1^*#	100	75.6	82.4^*#
ICA+IA2-Ab	15	27.8	100	62.5	67.2
GAD-Ab+IA2-Ab	33	61.1^*#	100	75.6	82.4^*#
ICA+GAD-Ab+IA2-Ab	33	61.1^*#	100	75.6	82.4^*#

[1]	LIANG Chaohui, ZHAO Fan, LIU Qianwen. Relationship between macrophage migration inhibitory factor and carotid vascular calcification in elderly patients with type 2 diabetes mellitus [J]. Laboratory Medicine, 2023, 38(5): 460-465.
[2]	DENG Xu, ZHUANG Wenlong, XUE Hui, ZHU Shuqin, LI Ying. Relationship between neutrophil/lymphocyte ratio，fibrinogen and carotid intima-media thickness in type 2 diabetes mellitus patients [J]. Laboratory Medicine, 2023, 38(4): 368-372.
[3]	CHEN Hui, CHEN Guanghui, LIANG Yingliang, WANG Wandang, YIN Zhijun. Screening hub genes and diagnostic analysis of gestational diabetes mellitus based on GEO database [J]. Laboratory Medicine, 2023, 38(3): 276-281.
[4]	KE Qiulei, HUANG Jing, CHEN Aizheng, SONG Yanfeng, SU Xiaofeng. Subgingival flora and the relations between periodontal health indexes and risk of periodontal disease in patients with GDM [J]. Laboratory Medicine, 2023, 38(2): 163-166.
[5]	WU Ying, ZHANG Lihong, GAO Yin. Predictive value of high-density lipoprotein cholesterol on the risk of cerebral ischemic stroke in type 2 diabetes mellitus patients [J]. Laboratory Medicine, 2023, 38(11): 1052-1056.
[6]	QIAN Linyu, LIANG Weifang, TANG Sichen. Determination and clinical significance of NLRP3，CTRP6 and IL-1β in patients with gestational diabetes mellitus [J]. Laboratory Medicine, 2023, 38(10): 936-940.
[7]	WANG Lingling, REN Chunli. Correlation of MTHFR gene C677T polymorphism and blood lipid levels with GDM [J]. Laboratory Medicine, 2022, 37(6): 543-546.
[8]	ZHANG Xiaoqin, ZHOU Yulan, FU Zhumei, HAN Xuexue, ZHAN Jie. Relationship of mtDNA T16189C mutation and gestational diabetes mellitus [J]. Laboratory Medicine, 2022, 37(5): 413-416.
[9]	QU Yuanqing, ZHAO Fan, YE Ailian, LI Lifeng, ZHAO Haitao, LI Huizhen, LIANG Zhuohui, LI Liang. Relationship between plasma omentin-1 level and metabolic clearance rate in type 2 diabetes mellitus patients [J]. Laboratory Medicine, 2022, 37(1): 28-31.
[10]	YUE Daoyuan, CHEN Wei, LIAO Qing, YU Weiting, LI Huijun. Establishment and evaluation of Wuhan Glycohemoglobin Harmonization Program [J]. Laboratory Medicine, 2022, 37(1): 78-82.
[11]	LE Jiangman, LI Tianyuan, TAN Meiyu, WANG Yajie, ZHOU Lida, SHU Jie, WU Jiaoxiang, SUN Hanxiao, XUAN Binbin, CAI Xushan, SHENG Huiming. Correlation of gestational diabetes mellitus with plasma TMAO [J]. Laboratory Medicine, 2021, 36(8): 795-799.
[12]	WANG Yu, ZHANG Wenwen, LIU Meiling, LIU Xiaojuan. Relationship between AFP,free-βHCG,uE3 and GDM in the second trimester of pregnancy [J]. Laboratory Medicine, 2021, 36(8): 828-832.
[13]	WANG Wei, WANG Lei, WANG Beili, ZHOU Fangfang, HU Jun, WU Pei, YIN Fen, YUAN Kaiying, HOU Yumin, DIAO Duanqin, LI Guoying, CHEN Min, GAO Yuhong. Establishment and preliminary evaluation of HbA_1c determination harmonization plan of Xuhui District of Shanghai [J]. Laboratory Medicine, 2021, 36(5): 549-553.
[14]	ZHU Qinghua, WANG Weiwei, ZOU Guanghui, DONG Zhiwu. Combined detection of serum NGAL and Cys C in the diagnosis of early nephropathy in patients with type 2 diabetes mellitus [J]. Laboratory Medicine, 2021, 36(3): 281-284.
[15]	ZHOU Lifang, PAN Shun, TANG Zhenhua. Application of Raman spectroscopy in the diagnosis of gestational diabetes mellitus [J]. Laboratory Medicine, 2021, 36(3): 313-317.