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High levels of antigen-specific islet antibodies predict future β-cell failure in patients with onset of diabetes in adult age

Borg, H. LU ; Gottsäter, A. LU ; Landin-Olsson, M. LU ; Fernlund, P. and Sundkvist, G. LU (2001) In Journal of Clinical Endocrinology and Metabolism 86(7). p.3032-3038
Abstract

It is unclear whether high levels of antigen-specific islet antibodies [GADA (glutamic acid decarboxylase 65 antibodies) and IA2-ab (protein tyrosine phosphatase-like protein antibodies)] predict β-cell failure in patients with onset of diabetes in adult age. Therefore, GADA and IA2-ab levels at the diagnosis of diabetes were related to fasting plasma C-peptide levels 5 yr later in 148 patients with diabetes onset in adult age (age at onset, 20-77 yr; median, 57 yr). Classical islet cell antibodies (ICA) were also determined. Complete β-cell failure (undetectable fasting plasma C-peptide) was only present in 4 patients at diagnosis of diabetes, but in 21 patients 5 yr thereafter. At diagnosis, ICA were detected in 20 of 21 (95%)... (More)

It is unclear whether high levels of antigen-specific islet antibodies [GADA (glutamic acid decarboxylase 65 antibodies) and IA2-ab (protein tyrosine phosphatase-like protein antibodies)] predict β-cell failure in patients with onset of diabetes in adult age. Therefore, GADA and IA2-ab levels at the diagnosis of diabetes were related to fasting plasma C-peptide levels 5 yr later in 148 patients with diabetes onset in adult age (age at onset, 20-77 yr; median, 57 yr). Classical islet cell antibodies (ICA) were also determined. Complete β-cell failure (undetectable fasting plasma C-peptide) was only present in 4 patients at diagnosis of diabetes, but in 21 patients 5 yr thereafter. At diagnosis, ICA were detected in 20 of 21 (95%) patients with β-cell failure after 5 yr and in only 7 of 127 (5%) without, whereas GADA and/or IA2-ab (>97.5 percentile of healthy controls) were detected in all 21 (100%) with but also in 23 of 127 (18%) patients without β-cell failure after 5 yr. Thus, ICA had a higher positive predictive value (74%) than GADA and/or IA2-ab (47%; P < 0.05). With high cutoff values for GADA and IA2-ab, however, GADA and/or IA2-ab were detected in 19 of 21 (90%) patients with β-cell failure vs. only in 5 of 127 (4%) without, giving a positive predictive value of 79%. Slightly elevated GADA levels in IA2-ab-negative patients were associated with progressive but not complete β-cell failure within the study period. Hence, high GADA and/or IA2-ab levels predict a future complete β-cell failure, whereas low GADA levels predict slowly progressive β-cell insufficiency.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Clinical Endocrinology and Metabolism
volume
86
issue
7
pages
3032 - 3038
publisher
Oxford University Press
external identifiers
  • scopus:0034920605
  • pmid:11443164
ISSN
0021-972X
DOI
10.1210/jc.86.7.3032
language
English
LU publication?
yes
id
a78c4de8-8c97-47a6-bdf0-ea2c80bb5dc1
date added to LUP
2020-12-11 14:29:32
date last changed
2021-06-23 06:16:29
@article{a78c4de8-8c97-47a6-bdf0-ea2c80bb5dc1,
  abstract     = {<p>It is unclear whether high levels of antigen-specific islet antibodies [GADA (glutamic acid decarboxylase 65 antibodies) and IA2-ab (protein tyrosine phosphatase-like protein antibodies)] predict β-cell failure in patients with onset of diabetes in adult age. Therefore, GADA and IA2-ab levels at the diagnosis of diabetes were related to fasting plasma C-peptide levels 5 yr later in 148 patients with diabetes onset in adult age (age at onset, 20-77 yr; median, 57 yr). Classical islet cell antibodies (ICA) were also determined. Complete β-cell failure (undetectable fasting plasma C-peptide) was only present in 4 patients at diagnosis of diabetes, but in 21 patients 5 yr thereafter. At diagnosis, ICA were detected in 20 of 21 (95%) patients with β-cell failure after 5 yr and in only 7 of 127 (5%) without, whereas GADA and/or IA2-ab (&gt;97.5 percentile of healthy controls) were detected in all 21 (100%) with but also in 23 of 127 (18%) patients without β-cell failure after 5 yr. Thus, ICA had a higher positive predictive value (74%) than GADA and/or IA2-ab (47%; P &lt; 0.05). With high cutoff values for GADA and IA2-ab, however, GADA and/or IA2-ab were detected in 19 of 21 (90%) patients with β-cell failure vs. only in 5 of 127 (4%) without, giving a positive predictive value of 79%. Slightly elevated GADA levels in IA2-ab-negative patients were associated with progressive but not complete β-cell failure within the study period. Hence, high GADA and/or IA2-ab levels predict a future complete β-cell failure, whereas low GADA levels predict slowly progressive β-cell insufficiency.</p>},
  author       = {Borg, H. and Gottsäter, A. and Landin-Olsson, M. and Fernlund, P. and Sundkvist, G.},
  issn         = {0021-972X},
  language     = {eng},
  number       = {7},
  pages        = {3032--3038},
  publisher    = {Oxford University Press},
  series       = {Journal of Clinical Endocrinology and Metabolism},
  title        = {High levels of antigen-specific islet antibodies predict future β-cell failure in patients with onset of diabetes in adult age},
  url          = {http://dx.doi.org/10.1210/jc.86.7.3032},
  doi          = {10.1210/jc.86.7.3032},
  volume       = {86},
  year         = {2001},
}