人类巨细胞病毒感染致1型糖尿病机制的初步探讨

目的通过对1型糖尿病患者的HCMV感染标志物、空腹血糖、空腹C肽、胰岛素自身抗体及抗胰岛细胞抗体的研究，初步探讨HCMV致1型糖尿病的机制。方法检测1型糖尿病患者的HCMV感染标志物（包括HCMV—IgG及其相对含量、HCMV—IgM及HCMV—pp65）、空腹血糖、C肽、抗胰岛素自身抗体及抗胰岛细胞抗体并进行统计学分析。结果HCMV感染与1型糖尿病患者抗胰岛素自身抗体之间无明显相关性，但与1型糖尿病患者空腹血糖、空腹C肽、抗胰岛细胞抗体存在明显的相关性，HCMV—pp65阳性的1型糖尿病患者中其空腹血糖明显高于该指标阴性者；抗HCMV—IgG阳性的1型糖尿病患者空腹血糖水平、抗胰岛细胞抗体均显著高于抗HCMV—IgG阴性者，而空腹C肽水平则明显低于抗HCMV—IgG阴性者，且抗HCMV—IgG抗体指数在4．1以上者，其抗胰岛细胞抗体阳性率显著高于抗HCMV—IgG抗体指数在4．0以下者。结论HCMV感染可能通过直接损伤胰岛免疫病理反应损伤胰岛细胞最终导致1型糖尿病的发生。

The pathogenesis of type 1 diabetes induced by human cytomegalovirus

Objective To investigate the pathogenesis of type 1 diabetes induced by human eytomegalovirus （HCMV）. Methods The detection of HCMV infection index （containing HCMV- IgG and its Comparative content, HCMV - IgM, HCMV pp65）, fasting plasma glucose, fasting plasma C peptide, insulin autoantibody（IAA） and insular cellular antibody（ICA） in type 1 diabetes were carried out by means of ELISA, Immunohistoehemistry technology and biochemistry, respectively. And the statistic analysis was performed by SPSS10.0 for WINDOWS. Results No association was found between HCMV infection and insulin autoantibodies in type 1 diabetes, while an obvious relativity was found between HCMV infection and fasting plasma glucose, fasting plasma e peptide and insular cellular antibody. The level of fasting plasma glucose in type 1 diabetes patients with HCMV - pp65 was much higher than that of in HMCV - pp65 negative ones, and the level of fasting plasma glucose and the positive rate of insular cellular antibody in type 1 diabetes patients with positive result of HCMV - IgG was significant higher than that of in HCMV- IgG negative ones, moreover, the positive rate of insular cellular antibody in type 1 diabetes patients with HCMV - IgG antibody index over 4.1 was much higher than that of in patients with HCMV - IgG antibody index under 4.0. Conclusion The pathogenesis of type 1 diabetes induced by human eytomegalovirus may be mediated by the disruption of islet beta cell via immunity pathological reaction.