Adult-onset autoimmune diabetes identified by glutamic acid decarboxylase autoantibodies: a retrospective cohort study

Diabetologia ◽  
2021 ◽  
Author(s):  
Eri Wada ◽  
Takeshi Onoue ◽  
Tamaki Kinoshita ◽  
Ayaka Hayase ◽  
Tomoko Handa ◽  
...  
Keyword(s):  
Cohort Study ◽  
Glutamic Acid ◽  
Glutamic Acid Decarboxylase ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Autoimmune Diabetes ◽  
Acid Decarboxylase ◽  
Adult Onset ◽  
Glutamic Acid Decarboxylase Autoantibodies

scholarly journals Number of autoantibodies and HLA genotype, more than high titers of glutamic acid decarboxylase autoantibodies, predict insulin dependence in latent autoimmune diabetes of adults

2010 ◽  
Vol 163 (4) ◽  
pp. 541-549 ◽  
Author(s):  
M Maioli ◽  
G M Pes ◽  
G Delitala ◽  
L Puddu ◽  
A Falorni ◽  
...  
Keyword(s):  
Glutamic Acid ◽  
Disease Progression ◽  
Glutamic Acid Decarboxylase ◽  
Autoimmune Diabetes ◽  
Tyrosine Phosphatase ◽  
Female Gender ◽  
Acid Decarboxylase ◽  
Latent Autoimmune Diabetes ◽  
Insulin Dependence ◽  
Glutamic Acid Decarboxylase Autoantibodies

ObjectiveIn latent autoimmune diabetes of adults (LADA), the progression into insulin-dependent diabetes is usually faster than in type 2 diabetes (T2D) but the factors influencing this progression are not completely known. In this study, we searched for sensitive markers associated with early development of insulin dependence.DesignThe screening of 5568 T2D patients for glutamic acid decarboxylase autoantibodies (GAD65Ab) identified 276 LADA patients (M=131; F=145) and in 251 of them, tyrosine phosphatase-2 (IA-2Ab) and thyroperoxidase autoantibodies (TPOAbs), some clinical features and genotype variation of the main type 1 diabetes (T1D) disease susceptibility loci (HLA-DRB1 and HLA-DQB1) were analyzed.ResultsFour years after the diagnosis of diabetes, high GAD65Ab titer was not significantly associated with faster progression toward insulin deficiency (P=0.104). Patients with GAD65Ab and TPOAb or IA-2Ab or triple positivity for both islet and TPOAbs (GAD65Ab/IA-2Ab/TPOAb) showed a significantly faster disease progression (P=0.002). Among 104 TPOAb-positive LADA patients, 10 received replacement therapy (l-thyroxine), 43 showed high TSH levels (62.7% developed insulin dependence), and 3 had hyperthyroidism treated with methimazole. Multivariate analysis revealed a significant effect on disease progression only for TPOAb (P=0.022), female gender (P=0.036), low body mass index (BMI; P=0.001), and T1D high/intermediate risk HLA-DRB1/DQB1 genotypes grouped (P=0.020).ConclusionsHigh GAD65Ab titers per se are not a major risk factor for disease progression in LADA, while the number of positive autoantibodies and HLA DRB1-DQB1 genotypes at high risk for T1D are significant predictors. Moreover, clinical characteristics such as low BMI and female gender are more likely to identify patients who will require insulin therapy within 4 years of diagnosis.

Sign in / Sign up

Export Citation Format

Share Document