PDF(Pubmed)
Abstract：
BACKGROUND: The prevalence of obesity has increased in patients with type 1 diabetes (T1D) and latent autoimmune diabetes of the adult (LADA), limiting the use of clinical features such as the body mass index for its differentiation with type 2 diabetes (T2D). Additionally, some patients with maturity-onset diabetes of the young (MODY) or LADA are misdiagnosed as having T2D. The evaluation of autoantibodies and genetic testing are not fully available. We aimed to evaluate the utility of a widely available and less expensive diagnostic tool such as C-peptide to differentiate between T1D, T2D, MODY, and LADA.
METHODS: Our study included 38 patients with T1D, 49 with T2D, 13 with MODY, and 61 with LADA. We recorded anthropometric measurements, biochemical profiles, and antidiabetic treatment and determined C-peptide, anti-GAD65, and anti-IA2 antibodies.
RESULTS: C-peptide concentration differed significantly among populations (T1D: 0.2 ng/mL; T2D: 2.4 ng/mL; MODY: 1.14 ng/mL; LADA: 1.87 ng/mL). Through a ROC curve, we observed that the C-peptide cut-off point of 0.95 ng/mL allows differentiation between T1D and T2D (sensitivity 82%, specificity 77%); 0.82 ng/mL between T1D and LADA (sensitivity 82%, specificity 77%); and 1.65 ng/mL between T2D and MODY (sensitivity 72%, specificity 72%).
CONCLUSIONS: C-peptide is useful for the diagnostic differentiation of patients with type 1, type 2 diabetes, MODY, and LADA.
METHODS: Our study included 38 patients with T1D, 49 with T2D, 13 with MODY, and 61 with LADA. We recorded anthropometric measurements, biochemical profiles, and antidiabetic treatment and determined C-peptide, anti-GAD65, and anti-IA2 antibodies.
RESULTS: C-peptide concentration differed significantly among populations (T1D: 0.2 ng/mL; T2D: 2.4 ng/mL; MODY: 1.14 ng/mL; LADA: 1.87 ng/mL). Through a ROC curve, we observed that the C-peptide cut-off point of 0.95 ng/mL allows differentiation between T1D and T2D (sensitivity 82%, specificity 77%); 0.82 ng/mL between T1D and LADA (sensitivity 82%, specificity 77%); and 1.65 ng/mL between T2D and MODY (sensitivity 72%, specificity 72%).
CONCLUSIONS: C-peptide is useful for the diagnostic differentiation of patients with type 1, type 2 diabetes, MODY, and LADA.
摘要：
背景：1型糖尿病（T1D）和成人隐匿性自身免疫性糖尿病（LADA）患者的肥胖患病率增加，限制使用临床特征，如体重指数，以区分2型糖尿病（T2D）。此外,一些患有青年成年型糖尿病（MODY）或LADA的患者被误诊为T2D。自身抗体和基因检测的评估并不完全可用。我们的目的是评估广泛可用且较便宜的诊断工具（如C肽）的实用性，以区分T1D，T2D,MODY,还有LADA.
方法：我们的研究包括38例T1D患者，49与T2D，13与MODY，和61与LADA。我们记录了人体测量,生化概况,和抗糖尿病治疗和确定的C肽，抗GAD65和抗IA2抗体。
结果：C肽浓度在人群之间存在显着差异（T1D：0.2ng/mL；T2D：2.4ng/mL；MODY：1.14ng/mL；LADA：1.87ng/mL）。通过ROC曲线,我们观察到0.95ng/mL的C肽截止点允许T1D和T2D之间的区别（灵敏度为82%，特异性77%)；T1D和LADA之间为0.82ng/mL(灵敏度82%，特异性77%)；T2D和MODY之间为1.65ng/mL(灵敏度72%，特异性72%)。
结论：C肽对1型、2型糖尿病患者的诊断鉴别有用，MODY,还有LADA.
方法：我们的研究包括38例T1D患者，49与T2D，13与MODY，和61与LADA。我们记录了人体测量,生化概况,和抗糖尿病治疗和确定的C肽，抗GAD65和抗IA2抗体。
结果：C肽浓度在人群之间存在显着差异（T1D：0.2ng/mL；T2D：2.4ng/mL；MODY：1.14ng/mL；LADA：1.87ng/mL）。通过ROC曲线,我们观察到0.95ng/mL的C肽截止点允许T1D和T2D之间的区别（灵敏度为82%，特异性77%)；T1D和LADA之间为0.82ng/mL(灵敏度82%，特异性77%)；T2D和MODY之间为1.65ng/mL(灵敏度72%，特异性72%)。
结论：C肽对1型、2型糖尿病患者的诊断鉴别有用，MODY,还有LADA.
