中国医药科学2025，Vol.15Issue(9)：154-159,6.DOI:10.20116/j.issn2095-0616.2025.09.35
GADA检测在成人隐匿性自身免疫性糖尿病诊断中的临床应用研究
Clinical application of GADA detection in the diagnosis of adult latent autoimmune diabetes
摘要
Abstract
Objective To investigate the detection rate of latent autoimmune diabetes in adults(LADA)in newly diagnosed patients with type 2 diabetes mellitus(T2DM)and the value of glutamic acid decarboxylase antibody(GADA)in differentiating LADA from T2DM in clinical application.Methods A total of 113 newly diagnosed patients with T2DM admitted to and collected by the Department of Clinical Laboratory of Jiangsu Province Hospital of Chinese Medicine from January 2022 to January 2024 were selected as the research objects.GADA in their serum was detected,and the patients were divided into the LADA group and the T2DM group according to the diagnosis and treatment criteria.Clinical data and biochemical test results were compared between these two groups.To evaluate the diagnostic value of relevant indices in distinguishing LADA from T2DM,receiver operating characteristic(ROC)curves were plotted.Using decision tree machine learning models,indices were further evaluated and the effectiveness of LADA and T2DM were distinguished,and diagnosis was preliminarily predicted after training.Results In patients with initial diagnosis of T2DM and GADA>10 IU/ml,GADA had a very good discrimination ability between LADA and T2DM patients,with an AUC value of up to 0.801.C-peptide(CP)had good discrimination between LADA and T2DM patients,with an AUC value of 0.651.The discriminatory power of glycated hemoglobin(HbA1c)in distinguishing LADA and T2DM patients was limited,with an AUC value of 0.374,but it still had some statistical significance.The decision tree model not only validated the conclusions of descriptive,correlation,and ROC curve analysis,but also achieved a diagnostic prediction accuracy of 0.760 using GADA,CP,and HbA1c indices under small sample conditions.Conclusion GADA testing is an important index for screening LADA in patients with newly diagnosed T2DM,while CP and HbA1c are secondary indices that help improve the diagnostic accuracy of LADA.The results of this research support the application of GADA detection in clinical practice,combined with decision tree model to assist in the diagnosis of LADA,providing a new tool for early diagnosis and treatment of LADA.关键词
谷氨酸脱羧酶抗体/成人隐匿性自身免疫糖尿病/2型糖尿病/决策树模型/鉴别诊断Key words
Glutamic acid decarboxylase antibody/Latent autoimmune diabetes in adults/Type 2 diabetes mellitus/Decision tree model/Differential diagnosis分类
医药卫生引用本文复制引用
王瑶,滕凤猛,安晓飞,詹晓燕..GADA检测在成人隐匿性自身免疫性糖尿病诊断中的临床应用研究[J].中国医药科学,2025,15(9):154-159,6.基金项目
江苏省中医院创新发展基金专项课题(Y2020CX51). （Y2020CX51）
