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A 12-year prospective study of the relationship between islet antibodies and beta-cell function at and after the diagnosis in patients with adult-onset diabetes.

Borg, Henrik LU ; Gottsäter, Anders LU ; Fernlund, Per LU and Sundkvist, Göran LU (2002) In Diabetes 51(6). p.1754-1762
Abstract
To clarify the relationships between islet antibodies (islet cell antibody [ICA], GAD antibody [GADA], and IA-2 antibody [IA-2A]) versus the progression of beta-cell dysfunction, we have followed a group of diabetic patients from their diagnosis at 21-73 years of age. Patients with ICA had high levels of GADA and/or IA-2A at diagnosis and a more severe beta-cell dysfunction 5 years after diagnosis than those with only GADA in low concentrations. The aim of the current 12-year follow-up study was to examine the further progression of beta-cell dysfunction in relation to islet antibodies at and after diagnosis. Among 107 patients, complete beta-cell failure 12 years after diagnosis was restricted to those with islet antibodies at diagnosis... (More)
To clarify the relationships between islet antibodies (islet cell antibody [ICA], GAD antibody [GADA], and IA-2 antibody [IA-2A]) versus the progression of beta-cell dysfunction, we have followed a group of diabetic patients from their diagnosis at 21-73 years of age. Patients with ICA had high levels of GADA and/or IA-2A at diagnosis and a more severe beta-cell dysfunction 5 years after diagnosis than those with only GADA in low concentrations. The aim of the current 12-year follow-up study was to examine the further progression of beta-cell dysfunction in relation to islet antibodies at and after diagnosis. Among 107 patients, complete beta-cell failure 12 years after diagnosis was restricted to those with islet antibodies at diagnosis (16 of 21 [77%] with multiple antibodies and 4 of 5 [80%] with only GADA). In contrast, among antibody-negative patients, fasting P-C-peptide levels were unchanged. Most GADA-positive patients (22 of 27 [81%]) remained GADA positive after 12 years. Associated with decreasing fasting P-C-peptide levels (0.85 nmol/l [0.84] at diagnosis vs. 0.51 nmol/l [0.21] 12 years after diagnosis, P < 0.05), ICA developed after diagnosis in 6 of 105 originally antibody negative mostly overweight patients. In conclusion, multiple islet antibodies or GADA alone at diagnosis of diabetes predict future complete beta-cell failure. After diagnosis, GADA persisted in most patients, whereas ICA development in patients who were antibody negative at diagnosis indicated decreasing beta-cell function. (Less)
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organization
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type
Contribution to journal
publication status
published
subject
keywords
Diabetes Mellitus, Islets of Langerhans : immunology, Human, Islets of Langerhans : physiopathology, Isoenzymes : immunology, Middle Age, Prognosis, Prospective Studies, Support, Non-U.S. Gov't, Glutamate Decarboxylase : immunology, Non-Insulin-Dependent : physiopathology, Fasting, Non-Insulin-Dependent : immunology, Non-Insulin-Dependent : diagnosis, Adult, Aged, Autoantibodies : blood, C-Peptide : blood
in
Diabetes
volume
51
issue
6
pages
1754 - 1762
publisher
American Diabetes Association Inc.
external identifiers
  • pmid:12031962
  • wos:000175936700013
ISSN
1939-327X
DOI
10.2337/diabetes.51.6.1754
language
English
LU publication?
yes
id
a94b1cfb-e156-4423-9b94-39b9fd5b6bfe (old id 108547)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12031962&dopt=Abstract
date added to LUP
2007-07-16 10:47:29
date last changed
2016-04-16 03:56:09
@article{a94b1cfb-e156-4423-9b94-39b9fd5b6bfe,
  abstract     = {To clarify the relationships between islet antibodies (islet cell antibody [ICA], GAD antibody [GADA], and IA-2 antibody [IA-2A]) versus the progression of beta-cell dysfunction, we have followed a group of diabetic patients from their diagnosis at 21-73 years of age. Patients with ICA had high levels of GADA and/or IA-2A at diagnosis and a more severe beta-cell dysfunction 5 years after diagnosis than those with only GADA in low concentrations. The aim of the current 12-year follow-up study was to examine the further progression of beta-cell dysfunction in relation to islet antibodies at and after diagnosis. Among 107 patients, complete beta-cell failure 12 years after diagnosis was restricted to those with islet antibodies at diagnosis (16 of 21 [77%] with multiple antibodies and 4 of 5 [80%] with only GADA). In contrast, among antibody-negative patients, fasting P-C-peptide levels were unchanged. Most GADA-positive patients (22 of 27 [81%]) remained GADA positive after 12 years. Associated with decreasing fasting P-C-peptide levels (0.85 nmol/l [0.84] at diagnosis vs. 0.51 nmol/l [0.21] 12 years after diagnosis, P &lt; 0.05), ICA developed after diagnosis in 6 of 105 originally antibody negative mostly overweight patients. In conclusion, multiple islet antibodies or GADA alone at diagnosis of diabetes predict future complete beta-cell failure. After diagnosis, GADA persisted in most patients, whereas ICA development in patients who were antibody negative at diagnosis indicated decreasing beta-cell function.},
  author       = {Borg, Henrik and Gottsäter, Anders and Fernlund, Per and Sundkvist, Göran},
  issn         = {1939-327X},
  keyword      = {Diabetes Mellitus,Islets of Langerhans : immunology,Human,Islets of Langerhans : physiopathology,Isoenzymes : immunology,Middle Age,Prognosis,Prospective Studies,Support,Non-U.S. Gov't,Glutamate Decarboxylase : immunology,Non-Insulin-Dependent : physiopathology,Fasting,Non-Insulin-Dependent : immunology,Non-Insulin-Dependent : diagnosis,Adult,Aged,Autoantibodies : blood,C-Peptide : blood},
  language     = {eng},
  number       = {6},
  pages        = {1754--1762},
  publisher    = {American Diabetes Association Inc.},
  series       = {Diabetes},
  title        = {A 12-year prospective study of the relationship between islet antibodies and beta-cell function at and after the diagnosis in patients with adult-onset diabetes.},
  url          = {http://dx.doi.org/10.2337/diabetes.51.6.1754},
  volume       = {51},
  year         = {2002},
}