免疫检查点抑制剂相关糖尿病患者的抗体水平与胰岛功能无相关性

Antibody Levels Were Not Correlated with Islet Function in Patients with Checkpoint Inhibitor-Related Diabetes

摘要: 目的：探讨免疫检查点抑制剂相关糖尿病患者应用PD-1抑制剂治疗后胰岛素自身抗体阳性与胰岛功能的关系。方法：对5例免疫检查点抑制剂相关糖尿病患者进行回顾性研究。本文数据已通过本院伦理委员会审查。这些患者于2018年9月至2021年2月在青岛大学附属医院内分泌代谢科接受治疗。收集的数据包括性别、年龄、生存率、体重指数(BMI)、肿瘤类型、应用免疫抑制剂类型、发病周期、胰岛相关抗体、胰岛素和C肽水平。在查阅现有的中英文文献数据库(CNKI, Wanfang, VIP, PubMed, Web of Science)后，我们将患者分为胰岛抗体阳性组(22例)和胰岛抗体阴性组(23例)。使用卡方检验，Fisher精确检验和Whitney U检验，检验组间差异。结果：我们没有发现胰岛素相关抗体与胰岛功能之间的关联(p > 0.05)。由于单个统计量 < 1，Fisher检验结果为p = 0.233，p > 0.05。经Mann-Whitney U检验，抗体阳性组与抗体阴性组C肽水平无显著性差异(p > 0.05)。结论：检查点抑制剂相关糖尿病患者胰岛相关抗体水平与胰岛功能无明显相关性。

Abstract: Objective: The goal of this study was to investigate the relationship between positive insulin auto-antibodies and islet function in patients with checkpoint inhibitor-related diabetes mellitus who were treated with PD-1 inhibitors. Methods: A retrospective study was conducted regarding five pa-tients with checkpoint inhibitor-related diabetes mellitus. The data have been reviewed by the Ethics Committee of our hospital. These patients were treated in the Department of Endocrinology and Metabolism in the Affiliated Hospital of Qingdao University from September 2018 to February 2021. The data collected included sex, age, survival, body mass index (BMI), tumor type, immuno-suppressive agent type, onset cycle, insulin-related antibodies, insulin and c-peptide levels. After searching the existing Chinese and English literature databases (CNKI, Wanfang, VIP, PubMed, Web of Science) for additional case reports containing statistical data on insulin-related antibody and C-peptide levels (i.e., islet function), we divided patients into two groups: the insulin anti-body-positive group (22 cases) and the insulin antibody-negative group (23 cases). The differences between groups were tested using the chi-square test, Fisher’s exact test, and the Whitney U test. Results: We did not find an association between insulin-related antibodies and islet function (p > 0.05). Due to a single statistic being < 1, the results of the Fisher’s test were p = 0.233, p > 0.05. We also did not find a difference in the c-peptide levels between the antibody-positive group and the antibody-negative group with Mann-Whitney U test result of p > 0.05. Conclusions: There was no significant correlation between islet-associated antibody levels and islet function in patients with checkpoint inhibitor-related diabetes mellitus.