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HLA-DQB1 genotypes, islet antibodies and beta cell function in the classification of recent-onset diabetes among young adults in the nationwide Diabetes Incidence Study in Sweden.

Bakhtadze, Ekaterine LU ; Borg, Henrik LU ; Stenstrom, G; Fernlund, Per LU ; Arnqvist, H; Ekbom-Schnell, A; Bolinder, J; Eriksson, J; Gudbjornsdottir, S and Nystrom, L, et al. (2006) In Diabetologia 49(May 31). p.1785-1794
Abstract
The World Health Organization considers an aetiological classification of diabetes to be essential. The aim of this study was to evaluate whether HLA-DQB1 genotypes facilitate the classification of diabetes as compared with assessment of islet antibodies by investigating young adult diabetic patients. Blood samples were available at diagnosis for 1,872 (90%) of the 2,077 young adult patients (aged 15-34 years old) over a 5-year period in the nationwide Diabetes Incidence Study in Sweden. Islet antibodies were measured at diagnosis in 1,869 patients, fasting plasma C-peptide (fpC-peptide) after diagnosis in 1,522, while HLA-DQB1 genotypes were determined in 1,743. Islet antibodies were found in 83% of patients clinically considered to have... (More)
The World Health Organization considers an aetiological classification of diabetes to be essential. The aim of this study was to evaluate whether HLA-DQB1 genotypes facilitate the classification of diabetes as compared with assessment of islet antibodies by investigating young adult diabetic patients. Blood samples were available at diagnosis for 1,872 (90%) of the 2,077 young adult patients (aged 15-34 years old) over a 5-year period in the nationwide Diabetes Incidence Study in Sweden. Islet antibodies were measured at diagnosis in 1,869 patients, fasting plasma C-peptide (fpC-peptide) after diagnosis in 1,522, while HLA-DQB1 genotypes were determined in 1,743. Islet antibodies were found in 83% of patients clinically considered to have type 1 diabetes, 23% with type 2 diabetes and 45% with unclassifiable diabetes. After diagnosis, median fpC-peptide concentrations were markedly lower in patients with islet antibodies than in those without (0.24 vs 0.69 nmol/l, p < 0.0001). Irrespective of clinical classification, patients with islet antibodies showed increased frequencies of at least one of the risk-associated HLA-DQB1 genotypes compared with patients without. Antibody-negative patients with risk-associated HLA-DQB1 genotypes had significantly lower median fpC-peptide concentrations than those without risk-associated genotypes (0.51 vs 0.74 nmol/l, p=0.0003). Assessment of islet antibodies is necessary for the aetiological classification of diabetic patients. HLA-DQB1 genotyping does not improve the classification in patients with islet antibodies. However, in patients without islet antibodies, HLA-DQB1 genotyping together with C-peptide measurement may be of value in differentiating between idiopathic type 1 diabetes and type 2 diabetes. (Less)
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subject
keywords
C-peptide, islet antibodies, HLA-DQB1 genotypes, classification
in
Diabetologia
volume
49
issue
May 31
pages
1785 - 1794
publisher
Springer
external identifiers
  • wos:000238859900011
  • pmid:16783473
  • scopus:33745771093
ISSN
1432-0428
DOI
10.1007/s00125-006-0293-5
language
English
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yes
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e205987c-8c80-46ec-9e37-ee36e674c07c (old id 158242)
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http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16783473&dopt=Abstract
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2007-07-11 15:49:35
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2019-07-30 01:54:30
@article{e205987c-8c80-46ec-9e37-ee36e674c07c,
  abstract     = {The World Health Organization considers an aetiological classification of diabetes to be essential. The aim of this study was to evaluate whether HLA-DQB1 genotypes facilitate the classification of diabetes as compared with assessment of islet antibodies by investigating young adult diabetic patients. Blood samples were available at diagnosis for 1,872 (90%) of the 2,077 young adult patients (aged 15-34 years old) over a 5-year period in the nationwide Diabetes Incidence Study in Sweden. Islet antibodies were measured at diagnosis in 1,869 patients, fasting plasma C-peptide (fpC-peptide) after diagnosis in 1,522, while HLA-DQB1 genotypes were determined in 1,743. Islet antibodies were found in 83% of patients clinically considered to have type 1 diabetes, 23% with type 2 diabetes and 45% with unclassifiable diabetes. After diagnosis, median fpC-peptide concentrations were markedly lower in patients with islet antibodies than in those without (0.24 vs 0.69 nmol/l, p &lt; 0.0001). Irrespective of clinical classification, patients with islet antibodies showed increased frequencies of at least one of the risk-associated HLA-DQB1 genotypes compared with patients without. Antibody-negative patients with risk-associated HLA-DQB1 genotypes had significantly lower median fpC-peptide concentrations than those without risk-associated genotypes (0.51 vs 0.74 nmol/l, p=0.0003). Assessment of islet antibodies is necessary for the aetiological classification of diabetic patients. HLA-DQB1 genotyping does not improve the classification in patients with islet antibodies. However, in patients without islet antibodies, HLA-DQB1 genotyping together with C-peptide measurement may be of value in differentiating between idiopathic type 1 diabetes and type 2 diabetes.},
  author       = {Bakhtadze, Ekaterine and Borg, Henrik and Stenstrom, G and Fernlund, Per and Arnqvist, H and Ekbom-Schnell, A and Bolinder, J and Eriksson, J and Gudbjornsdottir, S and Nystrom, L and Groop, Leif and Sundkvist, Göran},
  issn         = {1432-0428},
  keyword      = {C-peptide,islet antibodies,HLA-DQB1 genotypes,classification},
  language     = {eng},
  number       = {May 31},
  pages        = {1785--1794},
  publisher    = {Springer},
  series       = {Diabetologia},
  title        = {HLA-DQB1 genotypes, islet antibodies and beta cell function in the classification of recent-onset diabetes among young adults in the nationwide Diabetes Incidence Study in Sweden.},
  url          = {http://dx.doi.org/10.1007/s00125-006-0293-5},
  volume       = {49},
  year         = {2006},
}