The Correlation Of Uteroglobin-Related Protein 1 With Latent Autoimmune Diabetes In Adults

ObjectiveTo investigate the correlation between uterine globulin associated protein 1(UGRP1)and adult latent autoimmune diabetes mellitus(LADA).Methods1.The expression of UGRP1 in pancreatic tissue of normal mice and type 1 diabetes mellitus(T1DM)was detected by immunohistochemical method.2.A total of 124 participants were selected,including 45 patients with LADA as the LADA group,41 patients with type 2 diabetes mellitus(T2DM)as the T2DM group,and 38 healthy people without diabetes as the control group.General information,diabetes-related indicators and serum UGRP1 levels were compared among the three groups.3.Spearman correlation was used to analyze the relationship between serum UGRP1 and diabetes related indicators.4.Binary Logistic regression was used to analyze whether UGRP1 was an independent risk factor for LADA.5.ROC curve analysis was used to explore the diagnostic value of UGRP1 in LADA.Results1.UGRP1 expression was negative in normal mice and partial positive in T1DM mice.2.There was no significant difference in age,height,white blood cells,neutrophils and aspartate aminotransferase(AST)among control group,T2DM group and LADA group(P>0.05).The difference was statistically significant(P<0.05)in weight,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),alanine aminotransferase(ALT),estimated glomerular filtration rate(eGFR),fasting blood glucose(FBG)and 2h postprandial blood glucose(2hPBG),C-peptide(FCP)and 2h postprandial C-peptide(2hCP),glycosylated hemoglobin(HbA1c),islet autoantibodies(GADAb,IA-2,ZnT8),etc.The weight,BMI,SBP,ALT,FCP and 2hCP of LADA group were lower than those of T2DM group,while eGFR,GADAb,IA-2 and ZnT8 of LADA group were higher than those of T2DM group,with statistical significance(P<0.05).DBP,FBG,2hPBG,HbA1c,GADAb,IA-2 and ZnT8 in LADA group were higher than those in control group,while ALT,FCP and 2hCP were lower than those in control group,the difference was statistically significant(P<0.05).Weight,BMI,SBP,DBP,FBG,2hPBG and HbAlc in T2DM group were higher than those in control group,while those in FCP and 2hCP were lower,the difference was statistically significant(P<0.05).3.Serum UGRP1 in control group,T2DM group and LADA group were 0.57(0.50,0.65)ng/ml,0.60(0.50,0.72)ng/ml and 0.88(0.66,2.51)ng/ml,respectively.Serum UGRP1 in LADA group was higher than that in control group,The difference was statistically significant(P<0.05).Serum UGRP1 in LADA group was higher than that in T2DM group,and the difference was statistically significant(P<0.05).There was no significant difference in serum UGRP1 between T2DM group and control group(P>0.05).4.Spearman correlation analysis showed that serum UGRP1 in diabetic patients was positively correlated with positive GADAb(r_s=0.412,P<0.05)and positive islet autoantibody number(r_s=0.404,P<0.05),and was negatively correlated with weight(r_s=-0.224,P<0.05),FCP(r_s=-0.274,P<0.05),2hCP(r_s=-0.336,P<0.05),and was not correlated with BMI,SBP,DBP,ALT,eGFR,FBG,2hPBG,HbA1c,IA-2,ZnT8.5.Binary Logistic regression analysis showed that serum UGRP1(OR=2.672,P<0.05)and 2hCP(OR=0.334,P<0.05)were independent risk factors for LADA.6.The area of UGRP1 under ROC curve was 0.774(95%CI:0.681～0.867,P<0.001),the maximum value of Yuden index was 0.509,the cut-off value of UGRP1 was 0.66 ng/ml,the sensitivity was 80.0%,and the specificity was 70.9%.The results suggest that UGRP1 can be used as a better assistant index to diagnose LADA.Conclusion:1.UGRP1 expression was partial positive in the islets of T1DM mice,peripheral blood UGRP1 of LADA patients is significantly higher than that of T2DM patients and normal people,and UGRP1 may be one of the reference indicators to distinguish LADA from T2DM.2.UGRP1 is positively correlated with GADAb-positive and the number of positive islet autoantibodies,and negatively correlated with C-peptide.UGRP1 is an independent risk factor for LADA.It is suggested that the expression of serum UGRP1 may be related to the autoimmune attack of pancreatic islets and may be involved in the pathogenesis of LADA,but its mechanism needs to be further explored.