Detection of islet autoantibody in new-onset diabetic patients with unprovoked ketosis / 中华全科医师杂志

ABSTRACT

Objective To investigate the distribution of islet autoantibodies (GAD-Ab, IA2-Ab, IAA) in new-onset diabetic patients with unprovoked ketosis and their association with clinical characteristics and pancreatic ? cell function.Methods Islet autoantibodies, including GAD-Ab、IA2-Ab and IAA were detected in 161 new-onset diabetic patients with unprovoked ketosis by radioligand assay. Prevalence of positive islet autoantibodies was compared among groups with different ages, body mass indexes (BMI), severity of ketosis and fasting C peptide (FCP) levels. Clinical characteristics and pancreatic ? cell function were compared between groups with positive and negative islet autoantibodies.Results One or more kinds of islet autoantibodies were detected in 68 from the 161 subjects (42.2%), with higher prevalence of positive islet autoantibodies in the patients aged equal to or less than 20 years, of BMI equal to or less than 18.5 and with FCP equal to or less than 300 pmol/L. Younger age of onset, lower BMI, more severe ketosis and poorer islet endocrine function were found in patients with positive islet autoantibodies, as compared with those with negative ones.Conclusions In diabetic patients with unprovoked ketosis, the younger, the lower C peptide and the lower BMI they are, the higher prevalence of positive islet autoantibodies, the more possibility that they are classified as type 1A diabetes and the less possibility as type 1B diabetes or type 2 diabetes.Pancreatic ? cell function was poorer in patients with positive islet autoantibodies,which should be treated with insulin as earlier as possible.