锌转运体 8 自身抗体（ZnT8A）有助于区分成人隐匿性自身免疫性糖尿病（LADA）与表型 2 型糖尿病。
Zinc transporter 8 autoantibody (ZnT8A) could help differentiate latent autoimmune diabetes in adults (LADA) from phenotypic type 2 diabetes mellitus.
机构信息
Diabetes Center, Second Xiangya Hospital, and Institute of Metabolism and Endocrinology, Key Laboratory of Diabetes Immunology, Ministry of Education, Central South University, Hunan Key Laboratory of Medical Epigenomics, Changsha, Hunan, China.
出版信息
Diabetes Metab Res Rev. 2013 Jul;29(5):363-8. doi: 10.1002/dmrr.2396.
BACKGROUND
The ZnT8A is an independent marker for diagnosis of type 1 diabetes mellitus. We investigated the distribution and clinical features of ZnT8A positive latent autoimmune diabetes in adult (LADA) patients to explore the potential diagnostic application.
METHODS
A total of 3062 phenotypic T2DM patients were randomly selected from a national multicenter study - the LADA China Study. Radioligand binding assays were applied to detect the presence of ZnT8A, GADA and IA-2A. HbA1c , fasting C-peptide and serum lipid levels were followed up with ZnT8A positive patients.
RESULTS
The positive prevalence of ZnT8A, GADA and IA-2A in phenotypic T2DM patients was 1.99% (61/3062), 6.43% (197/3062) and 1.96% (60/3062), respectively. The ZnT8A positivity was lower than that of GADA(x² = 74.8, p < 0.001) but was comparable with that of IA-2A (p > 0.05). The positivity of ZnT8A in IA-2A positive patients was higher than that in GADA positive patients (38.3% vs. 10.7%, x² = 24.8, p < 0.001). On the basis of GADA and IA-2A positivity, the ZnT8A assay enhanced the diagnostic prevalence of LADA from 7.58 to 8.62%. The LADA patients who were positive for ZnT8A had higher systolic blood pressure when compared with GADA positive cases (p = 0.049) and higher total cholesterol levels when compared with antibody-negative T2DM patients (p = 0.035).
CONCLUSION
The detection of ZnT8A at the basis of GADA and IA-2A can improve diagnostic sensitivity of Chinese LADA.
背景
ZnT8A 是 1 型糖尿病的独立诊断标志物。我们研究了成人隐匿性自身免疫性糖尿病（LADA）患者中 ZnT8A 阳性的分布和临床特征，以探讨其潜在的诊断应用价值。
方法
我们从一项全国多中心研究 - LADA 中国研究中随机选择了 3062 例表型 T2DM 患者。应用放射性配体结合试验检测 ZnT8A、GADA 和 IA-2A 的存在。对 ZnT8A 阳性患者进行 HbA1c、空腹 C 肽和血清脂质水平的随访。
结果
表型 T2DM 患者中 ZnT8A、GADA 和 IA-2A 的阳性检出率分别为 1.99%（61/3062）、6.43%（197/3062）和 1.96%（60/3062）。ZnT8A 的阳性检出率低于 GADA（x²=74.8，p<0.001），但与 IA-2A 相当（p>0.05）。IA-2A 阳性患者的 ZnT8A 阳性率高于 GADA 阳性患者（38.3% vs. 10.7%，x²=24.8，p<0.001）。在 GADA 和 IA-2A 阳性的基础上，ZnT8A 检测将 LADA 的诊断阳性率从 7.58%提高到 8.62%。与 GADA 阳性病例相比，ZnT8A 阳性的 LADA 患者的收缩压更高（p=0.049），与抗体阴性 T2DM 患者相比，总胆固醇水平更高（p=0.035）。
结论
在 GADA 和 IA-2A 的基础上检测 ZnT8A 可提高中国 LADA 的诊断敏感性。
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