RF陽性2型糖尿病患者の臨床像とその免疫学的背景に関する検討

It was reported that serum ICA-69 antibody levels in rheumatoid arthritis (RA) werehigher than diabetes mellitus (DM), but there were not so many clinical studies about type 2DM with rheumatoid factor positive. In this paper, we report the clinical and immunologicalcharacteristics of 256 outpatients with type 2 DM, that is to say, these are composed of 113patients with diets therapies, 115 patients with glibenclamide and 28 patients with insulin.In order to evaluate and investigate the clinical examinations and several auto-antibodies, suchas antinuclear antibody (ANA), rheumatoid factor (RF), antithyroid antibody (AMA and ATA)and anti-GAD antibody were tested respectively. In consequence of comparing 30 RF positivepatients and 226 RF negative patients, there were not significant differences of clinical characteristics,but high incidence for ANA and AMA were indicated in RF positive patients.According to the duration of diabetes, serum Hbalc levels changed, and it elevated from 6.9%(0-5 years from onset of diabetes) to 8.2% (6-10 years of deabetes). Furthermore significantlyhigh prevalence of autoantobodies in onset within 5 years was observed. And the rate ofpatients treated with insulin of RF positive group increased from 3.3% to 19.2% in a period of3 years. In addition, the tendency of negative corelation (r= 0.316, p<0.1) on the durationof diabetes and serum RF levels was recognized.From this study, it may be able to be indicated that RF and RA are related to the onsetand its exacerbations of type 2 DM.