ABSTRACT
@#Introduction: Diabetes-associated autoantibodies (DAA) is the hallmark of T1DM and LADA which are frequently tested in young diabetes patients. It was noted that up to 10-15% of patients with initial diagnosis of T2DM also exhibit DAA. Regardless of the classification, the presence of DAA suggests an underlying islet autoimmunity which lead to progressive pancreatic β-cell failure. There is limited data reported on DAA in young diabetes patients in Malaysia. This study aims to determine the frequency of DAA positivity and its association with demographic and clinical characteristics among this cohort. Methods: A retrospective study using secondary data obtained from Allergy and Immunology Research Centre, Institute for Medical Research, Malaysia. This study included 194 diabetes patients who were diagnosed before the age of 40 years old and tested for GADA, ICA, IA2A and IAA. Results: From 194 patients, 91 (46.9%) were positive for least one of the following DAA: ICA (79, 40.7%), GADA (61, 31.4%), IA2A (37, 19.1%) and IAA (9, 4.6%). Multiple positivity was higher (73.6%) compared to single positivity. Highest combination of double positivity was ICA+GADA (54, 59.3%) and triple positivity was ICA+GADA+IA2A (25, 27.5%). Simultaneous positivity of four autoantibodies was seen in only one (1.1%) patient. ICA, GADA and IA2A were associated with age group and ethnicity (all p < 0.001). Only IA2A was associated with gender (p = 0.012). Conclusions: GADA, ICA ad IA2A are more significant in young Malaysian diabetes patients. IAA has a very low frequency in this studied population.
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To determine the serological levels of inflammatory markers and autoimmunity in patients with T1D compared with controls, and determined its relation to the duration of diabetes. Methods: We selected 139 patients with T1D without chronic complications of diabetes, and 110 control subjects without family history of diabetes. Serological ultrasensitive C-reactive protein levels (usCRP), interleukin- 6 and adhesion protein VCAM through ELISA assay were determined. Autoimmune profile was also analyzed through GAD65, IA-2 and ZnT8 autoantibodies. Results: Increased levels of usCRP 1.74 (0.10 to 13.6) vs 1.08 (0.40 to 3.70) ng/ml (p < 0.03), VCAM 236.0 (122.2 to 693.5) vs 185.4 (101.3 to 421.3) ng/ml, p < 0.02 and IL-6 1.73 (0.40 to 9.10) vs 1.28 (0.30 to 4.60) ng/ml, p < 0.05 was found in the group of T1D patients compared with the control group. When analyzing inflammatory markers according to age groups (0-10 years and > 10 years), the values of usCRP were higher in the second group. There was no significant association between patients with DM1 and autoimmune positive profile with a higher frequency of markers of inflammation. Conclusions: These results suggest the presence of pro-inflammatory state is considerably more frequent in patients with T1D. The increased level of usCRP and IL -6 and according to age of the patients could indicate a possible role of adiposity and weight gain during the adolescence in the higher frequency of inflammatory markers in T1D patients...
Subject(s)
Humans , Male , Adolescent , Female , Child, Preschool , Child , Diabetes Mellitus, Type 1/immunology , Glutamate Decarboxylase/immunology , /immunology , C-Reactive Protein/immunology , Autoimmunity , Autoantibodies/analysis , Biomarkers , Glutamate Decarboxylase/analysis , Immunoenzyme Techniques , Inflammation , /analysis , C-Reactive Protein/analysisABSTRACT
25 year).The patients were analyzed for the clinical characteristics.Autoantibodies to glutamic acid decarboxylase 65(GAD65-Ab),insulin(I-Ab)and autoantobodies to protein tyrosine phosphatase-like proteins(IA2-Ab)were assayed.HLA-DRB1,DQA1,DQB1 alleles(HLA-DRB1*03,*04,*09,*15,DQB1*0201,*0302,*0601,DQA1*0301,*0501)were typing by PCR-sequence specific primer(PCR-SSP).Results A little higher proportion of males,a longer duration of disease; a higher BMI and WHR characterized the adult-onset patients.The adults have a higher level of triglycerides and 120 min C-peptides than adolescent.The frequency and level of IA2-Ab of the adolescents were higher than adults(47.1% vs 15.1% and 0.46 U?mL~ -1 vs 0.07 U?mL~ -1 ,respectively,P
ABSTRACT
BACKGROUND: The isoenzyme of glutamate decarboxylase (GAD), islet associated antigen (IA2, IAA) and insulin are known to be the major target antigens of pancreatic islet cell autoantibody as a predictor of type 1 diabetes mellitus (DM). Generally radioimmunoassay (RIA) methods are used for these autoantibodies but inconvenience of dealing with radioisotope have made enzyme-linked immunosorbent assay (ELISA) developed for clinical utilization. But, lack of evaluation or comparison studies of these two methods for autoantibodies make laboratories hesitate to adopt. METHODS: We measured the glutamate decarboxylase autoantibody (GADA), insulin autoantibody (IAA) and pancreatic islet cell autoantibodies (ICA) by a commercial ELISA method in 34 patients with type 1 DM, and 31 patients with type 2 DM, and 32 healthy control group. Conventional RIA was performed concurrently and compared for GADA and IAA. ICA was measured by conventional indirect immunofluorescent assay (IFA). The obtained results were compared and also C-peptide level was measured as a marker for residual function of islet cell of pancreas. RESULTS: Each autoantibody measured by ELISA in type 1 DM showed positive rate of 11.8% and for ICA, 26.5% for GADA, and 35.3% for IAA. The positive rate of the same group of type 1 DM when using RIA were 76.5% for GADA far exceeding that of ELISA method, and 29.4% for IAA. The percentage of positivity in combination of the ELISA methods for ICA and GAD yielded 29.4%, ICA plus IAA showed 38.2%, and GAD plus IAA was 52.9%, respectively. IAA positive rates in two groups divided by the age of 10 showed no significant difference. The presence of the autoantibodies did not influenced the C-peptide level. CONCLUSIONS: Further large scale studies including prediabetic state and autoimmune diabetes are required to establish the accurate diagnostic method of islet cell autoantibodies. But, presently ELISA method was considered that more improvement was needed for reliable and comparable results especially GADA.