Clinical and genetic characteristics of type 2 diabetes with and without GAD antibodies
| Autor: | Anita Nilsson, Kaj Lahti, Björn Forsén, Leif Groop, Bo Isomaa, A. Carlsson, B. Snickars, Tiinamaija Tuomi, Carola Saloranta, Haiyan Li, B.-O. Ehrnström, Marja-Riitta Taskinen, Michael Nissén, Aaro Miettinen, Carol Forsblom |
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| Rok vydání: | 1999 |
| Předmět: |
Male
Latent autoimmune diabetes of adults medicine.medical_specialty Genotype Endocrinology Diabetes and Metabolism Population Type 2 diabetes Impaired glucose tolerance Reference Values Interquartile range HLA-DQ Antigens Diabetes mellitus Internal medicine Glucose Intolerance Internal Medicine medicine HLA-DQ beta-Chains Humans Hypoglycemic Agents Insulin education Alleles Autoantibodies Type 1 diabetes education.field_of_study Polymorphism Genetic Glutamate Decarboxylase business.industry Middle Aged medicine.disease Diabetes Mellitus Type 1 Endocrinology Diabetes Mellitus Type 2 Female Metabolic syndrome business Polymorphism Restriction Fragment Length |
| Zdroj: | University of Helsinki |
| ISSN: | 1939-327X 0012-1797 |
| DOI: | 10.2337/diabetes.48.1.150 |
| Popis: | The aim of the study was 1) to establish the prevalence of GAD antibodies (GADab) in a population-based study of type 2 diabetes in western Finland, 2) to genetically and phenotypically characterize this subgroup, and 3) to provide a definition for latent autoimmune diabetes in adults (LADA). The prevalence of GADab was 9.3% among 1,122 type 2 diabetic patients, 3.6% among 558 impaired glucose tolerance (IGT) subjects, and 4.4% among 383 nondiabetic control subjects. Islet antigen 2 antibodies (IA2ab) or islet cell antibodies were detected in only 0.5% of the GADab- patients. The GADab+ patients had lower fasting C-peptide concentrations (median [interquartile range]: 0.46 [0.45] vs. 0.62 [0.44] nmol/l, P = 0.0002) and lower insulin response to oral glucose compared with GADab- patients. With respect to features of the metabolic syndrome, the GADab+ patients had lower systolic (140 [29.1] vs. 148 [26.0] mmHg, P = 0.009) and diastolic (79.2 [17.6] vs. 81.0 [13.1] mmHg, P = 0.030) blood pressure values, as well as lower triglyceride concentrations (1.40 [1.18] vs. 1.75 [1.25] mmol/l, P = 0.003). GADab+ men had a lower waist-to-hip ratio compared with GADab- patients. Compared with GADab- patients and control subjects, the GADab+ patients had an increased frequency HLA-DQB1*0201/0302 (13 vs. 4%; P = 0.002) and other genotypes containing the *0302 allele (22 vs. 12%; P = 0.010). However, the frequency of these high-risk genotypes was significantly lower in GADab+ type 2 patients than in type 1 diabetes of young or adult onset (0201/0302 or 0302/X: 36 vs. 66 vs. 64%, P < 0.001). The GADab+ type 2 group did not differ from control subjects with respect to genotypes containing the protective DQB1-alleles *0602 or *0603, nor with respect to the type 1 high-risk genotype in the IDDM1 (Hph1 +/+). We conclude that GADab+ patients differ from both GADab- type 2 diabetic patients and type 1 diabetic patients with respect to beta-cell function, features of the metabolic syndrome, and type 1 diabetes susceptibility genes. Further, we propose that LADA be defined as GADab positivity (>5 relative units) in patients older than 35 years at onset of type 2 diabetes. |
| Databáze: | OpenAIRE |
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