Improving clinical utility of GAD65 autoantibodies by electrochemiluminescence assay and clinical phenotype when identifying autoimmune adult-onset diabetes
| Autor: | Gu, Yong, Jia, Xiaofan, Vartak, Tanwi, Miao, Dongmei, Dong, Fran, Jerram, Samuel T, Rewers, Marian, Ferrara, Assiamira, Lawrence, Jean M, Yu, Liping, Leslie, R David, Beck-Nielsen, Henning, Yderstræde, Knud Bonnet |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
0301 basic medicine Oncology medicine.medical_specialty endocrine system Endocrinology Diabetes and Metabolism medicine.medical_treatment 030209 endocrinology & metabolism Type 2 diabetes Overweight ECL assay Article 03 medical and health sciences 0302 clinical medicine Diabetes mellitus Internal medicine Internal Medicine Humans Medicine Young adult Autoantibodies Type 1 diabetes Glutamate Decarboxylase business.industry Insulin Autoantibody Adult-onset diabetes Biomarker medicine.disease Diabetes Mellitus Type 1 Phenotype 030104 developmental biology Diabetes Mellitus Type 2 Biomarker (medicine) medicine.symptom business |
| Zdroj: | Gu, Y, Jia, X, Vartak, T, Miao, D, Dong, F, Jerram, S T, Rewers, M, Ferrara, A, Lawrence, J M, Yu, L, Leslie, R D, Action LADA consortium and the Diabetes in Young Adults (DiYA) Study Group, Beck-Nielsen, H & Yderstræde, K B 2021, ' Improving clinical utility of GAD65 autoantibodies by electrochemiluminescence assay and clinical phenotype when identifying autoimmune adult-onset diabetes ', Diabetologia, vol. 64, no. 9, pp. 2052-2060 . https://doi.org/10.1007/s00125-021-05492-6 Diabetologia |
| Popis: | Aims/hypothesis It is important to differentiate the two major phenotypes of adult-onset diabetes, autoimmune type 1 diabetes and non-autoimmune type 2 diabetes, especially as type 1 diabetes presents in adulthood. Serum GAD65 autoantibodies (GADA) are the most sensitive biomarker for adult-onset autoimmune type 1 diabetes, but the clinical value of GADA by current standard radiobinding assays (RBA) remains questionable. The present study focused on the clinical utility of GADA differentiated by a new electrochemiluminescence (ECL) assay in patients with adult-onset diabetes. Methods Two cohorts were analysed including 771 diabetic participants, 30–70 years old, from the Action LADA study (n = 6156), and 2063 diabetic participants, 20–45 years old, from the Diabetes in Young Adults (DiYA) study. Clinical characteristics of participants, including requirement of early insulin treatment, BMI and development of multiple islet autoantibodies, were analysed according to the status of RBA-GADA and ECL-GADA, respectively, and compared between these two assays. Results GADA was the most prevalent and predominant autoantibody, >90% in both cohorts. GADA positivity by either RBA or ECL assay significantly discriminated clinical type 1 from type 2 diabetes. However, in both cohorts, participants with ECL-GADA positivity were more likely to require early insulin treatment, have multiple islet autoantibodies, and be less overweight (for all p Conclusions/interpretation Detection of GADA by ECL assay, given technical advantages over RBA-GADA, identified adult-onset diabetes patients at higher risk of requiring early insulin treatment, as did clinical phenotype, together allowing for more accurate clinical diagnosis and management. Graphical abstract |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|