Analysis Of Clinical Features Of Graves’ Disease With Islet Autoantibodies

Objective1. Detection the positive rate of Graves, Disease(GD) with ICA、GADA、IA-2A and IAA.2. Research detection significance of pancreatic island autoantibodies andglycometabolic disorder in GD, Clear islet cell antibody test in the clinical value of GD.3.The further study of glycometabolic disorder in patients with GD.Methods Select165cases patients form Ningxia Medical University Hospital in April2011–April2012in department of endocrinology. Based on the method of ATD in GD weredivided in two groups.73cases in GDⅠgroup without received ATD outside hospital,other92cases in GDⅡgroup were received ATD.the75g oral glucose tolerance test(OGTT), ICA、GADA、IA-2A and IAA were detected in165patients. The general information of patientsand the laboratory parameters were underwent at the same time. The outcomes were thencompared.Results1.Two groups had no difference in age,WHR,BMI,and Blood pressure（P>0.05）, Femalepatients were more than male patients in two groups, there were47female patients(64.38%)in groupⅠ,58female patients(63.04%) in groupⅡ，but there were no difference in Sexratio;GDⅡhad a longer disease progression than GDⅠ（P<0.05）.2. The75g OGTT was underwent in165patients with GD.the outcome showed, fasting bloodglucose were normal and no hypoglycemia happened, there were42patients had abnormalglucose tolerance and11patients’ blood glucose levels Up to diabetes diagnosis criteria.3. GDⅡgroup had higher FT4and lower TSH than GDⅠgroup；there were no difference in TM-Ab、TG-Ab、TRAb between two groups.4. GDⅡgroup had higher GADA and IAA, lower ICA than GDⅡgroup. The positive rate ofcombined autoantibodies in two groups were all higher than single autoantibody.5.165patients were divided into three groups: negative antibody group were56patients;single GADA+group were28patients; single IA-2A+group were15patients. Theoutcomes were then compared. Single GADA+group and single IA-2A+group had alonger disease progression, higher2hours postprandial blood glucose, higher level ofHbA1c, and lower level of TSH than negative antibody group. Single GADA+group hadlower age of onset than negative antibody group, Single IA-2A+group had higher levelof FT4than negative antibody group.Conclusion1. GD patients had impaired glucose tolerance, mainly postprandial glucose abnormalities,fasting blood glucose were normal and no hypoglycemia happened. The abnormal glucosewas related to GD longer disease progression. A pathological increase of thyroid hormone,decreased insulin sensitivity and higher Liter sugar hormone had an affect on impairedglucose tolerance. Application of HbA1c in GD patients with blood glucose monitoring.2. ICA、IAA、GADA、IA-2A could be detected in GD patients. GADA, IA-2A positive ratewere higher, particular in the patients who had longer disease progression, higher level ofpostprandial blood glucose and HbA1c.at the same time associated with the level of thyroidhormone. GADA can be used for early GD patients with autoimmune reaction screening;IAA maybe related to the use of sulfydryl-containing drugs in GD patients. If you found thedetection of IAA positive in clinical. It would be vigilant IAS induced hypoglycemiareaction in GD patients; with disease progression, ICA decreased gradually. The positiverate of combined autoantibodies could effectively predict pancreatic beta cell function inGD patients and be great guiding significance in clinic.