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JCEM：年龄和抗体类型对1型糖尿病进展的影响（从单一到多种自身抗体）

2017-05-25 MedSci MedSci原创

1型糖尿病自身抗体年龄
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既往的研究已经证明胰岛自身抗体是1型糖尿病的标志物，在临床前阶段检测到的自身抗体数量的增加预示着显性疾病的进展。本研究的目的是为了明确年龄与胰岛抗体类型的对1型糖尿病患者从单一到多种自身抗体的进展的影响。研究人员在TrialNet途径预防研究中前瞻性地对994名糖耐量正常且有一个自身抗体阳性的1型糖尿病患者进行了研究。研究人员对参与者的谷氨酸脱羧酶抗体（GADA）、胰岛素（IAA）、IA-2（IA

既往的研究已经证明胰岛自身抗体是1型糖尿病的标志物，在临床前阶段检测到的自身抗体数量的增加预示着显性疾病的进展。本研究的目的是为了明确年龄与胰岛抗体类型的对1型糖尿病患者从单一到多种自身抗体的进展的影响。

研究人员在TrialNet途径预防研究中前瞻性地对994名糖耐量正常且有一个自身抗体阳性的1型糖尿病患者进行了研究。研究人员对参与者的谷氨酸脱羧酶抗体（GADA）、胰岛素（IAA）、IA-2（IA-2A，一种重要的胰岛细胞自身抗原），锌转运蛋白 8 (ZnT8A)和胰岛细胞抗体(ICA)每6-12个月进行一次检测。主要结果是多种自身抗体的进展。年龄分为：< 8岁；8-11岁；12-17岁；≥18岁，通过递归分区分析确定最佳年龄折点。

经过2年的随访，研究人员发现有141名患者疾病进展，被检测到额外≥1个自身抗体阳性。五年风险与年龄呈负相关，但因抗体类型的不同而影响程度不同：GADA阳性的患者在四个年龄组的风险逐渐减少，而IAA阳性的患者的风险在年龄8岁以上人群中急剧下降。递归分区分析表明最佳折点在GADA阳性患者中为14岁，而IAA阳性患者中为4岁。

研究人员认为在IAA阳性的1型糖尿病患者中，胰岛自身免疫的传播在很大程度上仅限于早期儿童，而针对GAD的免疫反应可能需要较长的时间。这些差异对未来抗体的监测和设计预防试验具有重要意义。

原始出处：

Bosi E, Boulware DC,et al.Impact of age and antibody type on progression from single to multiple autoantibodies in type 1 diabetes relatives.J Clin Endocrinol Metab. 2017 May 22. doi: 10.1210/jc.2017-00569. [Epub ahead of print]

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createdBy=8fd71930726, createdName=半夏微凉, createdTime=Fri May 26 05:49:45 CST 2017, time=2017-05-26, status=1, ipAttribution=)]
    2018-05-08 achengzhao

    #JCE#

    0

  2. 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createdBy=8fd71930726, createdName=半夏微凉, createdTime=Fri May 26 05:49:45 CST 2017, time=2017-05-26, status=1, ipAttribution=)]
    2017-09-04 smallant2015

    #JCEM#

    0

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    2017-05-26 明天会更好！

    文章很好，值得分享！

    0

  4. 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createdTime=Fri May 26 06:36:34 CST 2017, time=2017-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202625, encodeId=6bfa2026251c, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Fri May 26 06:07:37 CST 2017, time=2017-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202608, encodeId=65bc20260806, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Fri May 26 05:49:45 CST 2017, time=2017-05-26, status=1, ipAttribution=)]
    2017-05-26 dhzzm

    学习了分享了

    0

  5. 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createdTime=Fri May 26 06:36:34 CST 2017, time=2017-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202625, encodeId=6bfa2026251c, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Fri May 26 06:07:37 CST 2017, time=2017-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202608, encodeId=65bc20260806, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Fri May 26 05:49:45 CST 2017, time=2017-05-26, status=1, ipAttribution=)]
    2017-05-26 天涯183

    非常好的文章，学习了，很受益

    0

  6. 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createdTime=Fri May 26 06:36:34 CST 2017, time=2017-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202625, encodeId=6bfa2026251c, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Fri May 26 06:07:37 CST 2017, time=2017-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202608, encodeId=65bc20260806, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Fri May 26 05:49:45 CST 2017, time=2017-05-26, status=1, ipAttribution=)]
    2017-05-26 明月清辉

    谢谢分享，学习了

    0

  7. 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createdBy=8fd71930726, createdName=半夏微凉, createdTime=Fri May 26 05:49:45 CST 2017, time=2017-05-26, status=1, ipAttribution=)]
    2017-05-26 龙胆草

    学习谢谢分享

    0

  8. 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createdTime=Fri May 26 06:36:34 CST 2017, time=2017-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202625, encodeId=6bfa2026251c, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Fri May 26 06:07:37 CST 2017, time=2017-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202608, encodeId=65bc20260806, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Fri May 26 05:49:45 CST 2017, time=2017-05-26, status=1, ipAttribution=)]
    2017-05-26 忠诚向上

    好好努力学习

    0

  9. 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createdTime=Fri May 26 06:36:34 CST 2017, time=2017-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202625, encodeId=6bfa2026251c, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Fri May 26 06:07:37 CST 2017, time=2017-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202608, encodeId=65bc20260806, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Fri May 26 05:49:45 CST 2017, time=2017-05-26, status=1, ipAttribution=)]
    2017-05-26 刘煜

    学习了谢谢分享

    0

  10. 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createdBy=8fd71930726, createdName=半夏微凉, createdTime=Fri May 26 05:49:45 CST 2017, time=2017-05-26, status=1, ipAttribution=)]
    2017-05-26 半夏微凉

    学习了谢谢分享

    0

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