| Objective:Our study Compares and analyzes the positive rate of islet autoantibodies (including GAD A, ICA and IAA) and the level of islet function among the non-obese new -onset adult diabetes and the obese new-onset adult diabetes, which can provide the basis for the screening of Latent autoimmune diabetes in adults (LADA) and also can help us understand the clinical features of GADA positive new -onset adult diabetic patients to guide the clinical treatment.Methods:133 new -onset cases of adult diabetes were collected, which hospitalized in our hospital from 2014 to 2015, we divided those diabetic patients into two groups:obesity group 46 cases (BMI>25 kg/m2,male 30 cases, female 16 cases), non-obesity group 87 cases (BMI< 25 kg/m2, male 54 cases, female 33 cases). The value of GADA,ICA and IAA in these patients were detected, and the positive rates of the three islet autoantibodies between the two groups were analyzed. Then we Compare the clinical characteristics of the two groups, including age, FPG,2hPG, fasting C peptide, postprandial 2 h C peptide, glycosylated hemoglobin (HbAlc), urine ketone. Moreover, the 133 new -onset adult diabetic patients were divided into GADA positive group and negative group according to the positive and negative of GADA, then we Compare the clinical characteristics of two groups, including ICA, IAA, age, FPG,2hPG, fasting C peptide, postprandial 2 h C peptide, HbAlc and urine ketone. The detection rate of LADA was compared among the non-obese and obese GADA positive diabetic patients.Results:1.the positive rate of GADA in non-obese new-onset adult diabetes was 19.5%(17/87), and the positive rate of GADA in obese new-onset adult diabetes was 6.5%(3/46). The GADA positive rates of non-obese group was significantly higher than those of obese group by comparing the two groups, (x2=3.992, P=0.046< 0.05).2.There was no significant difference between the obese and non-obese groups in positive rates of IAA and ICA (P> 0.05).3.The levels of fasting C-peptide and the postprandial 2 h C peptide among non-obese new-onset adult diabetes were lower than those of the obese group (Z=-2.415, P = 0.016; Z=-2.725, P< 0.05), respectively.4. There were no statistical significance of differences of FPG,2hPG, HbAlc, age, positive rate oiurine ketone between non-obesity group and obesity group (P= 0.677,0.675,0.549, 0.356 and 0.551, respectively).5. BMI value of GADA positive new-onset adult diabetic patients was lower than GADA negative group (t=3.307, P=0.001< 0.05).6. The fasting C-peptide and postprandial 2 h C-peptide levels of GADA positive group were significantly lower than that of GADA negative group (Z=-3.053, P= 0.002< 0.05; Z=-3.497, P= 0.00< 0.05. respectively).7. The FPG of GADA positive group was higher than that in GADA negative group (t=-2.301, P=0.023< 0.05). There was no significant difference in 2hPG, glycosylated hemoglobin (HbAlc) and age between the two groups.8. The frequency of urine ketone in GADA positive new -onset adult diabetic patients was 50%(10/20), however, The frequency of urine ketone in GADA negative group was only 25.7%(29/113). The GADA positive group frequency was much higher than that in GADA negative group (x2=4.956, P= 0.028).9. Among the GADA positive new-onset adult diabetic patients, the total number of non-obese patients is 17, and 9 cases were diagnosed with LADA (9/17). However, only 3 cases of the GADA positive group were obese, and 2 cases of them were diagnosed with LADA (2/3).Conclusion:1.Islet autoantibodies, especially GADA, were detected among the non-obese new-onset adult diabetes, which is more favorable for LADA screening.2. Detection of islet autoantibodies in patients with low BMI and poor islet function is helpful for LADA screening, and using insulin early is favour of protecting the residual islet B cells. |
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