标题：佛山地区初诊2型糖尿病患者中LADA的患病率调查

      作者：黄秉文，方咏红，卢颖瑜，谢文卿
    （佛山市第二人民医院内分泌科，广东 佛山 528000）

      卷次： 2015年26卷5期

      【摘要】 目的 调查佛山地区临床初诊2型糖尿病患者中成人隐匿性自身免疫性糖尿病(LADA)的患病率
及其与2型糖尿病临床特点的差别。方法 对526例临床初诊为2型糖尿病患者用化学发光法测定谷氨酸脱羧
酶抗体(GAD-Ab)、酪氨酸磷酸酶蛋白抗体(ICA-Ab)及胰岛素自身抗体(IAA-Ab)，计算LADA的患病率并分析其
临床特点。结果 (1)临床初诊2型糖尿病患者中LADA患者检出率为5.9% (31/526)，其中GAD-Ab、ICA-Ab及
IAA-Ab的阳性检出率为5.2%、2.3%及0.9%。(2)病程1年内的初诊2型糖尿病患者其LADA检出率为11.3%，高
于病程1年以上患者的4.6% (P<0.05)。(3) LADA检出率与患者的临床特征有关，无家族发病史、低体重、低C-肽
水平及发病年龄小者有较高LADA发生风险。(4) 43.6%的LADA患者伴有两种以上代谢异常，其患病率由高到
低依次为：血脂异常、高血压、肥胖。在LADA患者中有16.1%的代谢综合征(MS)患病率。结论 (1)临床初诊为
2型糖尿病患者中有5.9%为LADA，应及早进行糖尿病抗体检测及临床干预。(2)超过2/5的LADA患者有多种
代谢异常，提示LADA患者应进行代谢方面检查以进行早期干预。

      【关键词】 成人隐匿性自身免疫性糖尿病；谷氨酸脱羧酶抗体；酪氨酸磷酸酶蛋白抗体；胰岛素自身抗体；患病率

      【中图分类号】 R587.1 【文献标识码】 A 【文章编号】 1003—6350（2015）05—0641—04


Study on prevalence of latent autoimmune diabetes in adults from phenotypic type 2 diabetic patients of
Foshan.
HUANG Bing-wen, FANG Yong-hong, LU Ying-yu, XIE Wen-qing. Department of Endocrinology, the Second
People's Hospital of Foshan, Foshan 528000, Guangdong, CHINA

【Abstract】 Objective To investigate the prevalence, clinical features of latent autoimmune diabetes in adults
(LADA) from phenotypic type 2 diabetic patients in Foshan. Methods Serum from 526 phenotypic type 2 diabetic
patients were screened for glutamic acid decarboxylase autoantibody (GAD-Ab), anti-islet cell autoantibody (ICA-Ab)
and anti-insulin autoantibody (IAA-Ab) through radioligand binding assay. The prevalence of LADA and its relation
with clinical features were analyzed. Results (1) The prevalence of LADA in phenotypic type 2 diabetic patients was
5.9% (31/526). The positive frequency of GAD-Ab, ICA-Ab and IAA-Ab was 5.2%, 2.3% and 0.9%, respectively.
(2) The prevalence of LADA from phenotypic type 2 diabetic patients with a duration of diabetic less than 1 year was
significantly higher than that of patients with a duration over 1 year (11.3% vs 4.6%, P<0.05). (3) The prevalence of
LADA was higher in patients with younger age at onset, lower body mass index and lower level of postprandial C pep-
tide and without diabetes family history. (4) 43.6% of LADA patients suffered from at least one kind of metabolic dis-
orders besides hyperglycemia, 16.1% of which were with MS. The metabolic disorders of prevalence from high to low
were as follows: hypertension, dyslipidemia, overweight/obesity. Conclusion (1) 5.9% of phenotypic type 2 diabetic
patients had LADA, which should be given early diagnosis of diabetic type and clinical intervention. (2) Approximate-
ly 2/5 patients with MS were found in LADA patients, indicating that overall screening and intervention of metabolic
disorder factors is important in LADA patients.

      【Key words】 Latent autoimmune diabetes in adults; Glutamic acid decarboxylase autoantibody; Anti-islet cell