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Glutamic acid decarboxylase antibodies are indicators of the course, but not of the onset, of diabetes in middle-aged adults: the Atherosclerosis Risk in Communities Study
Vigo, A; Duncan, B. B; Schmidt, M. I; Couper, D; Heiss, G; Pankow, J. S; Ballantyne, C. M.
  • Vigo, A; Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Porto Alegre. BR
  • Duncan, B. B; Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Porto Alegre. BR
  • Schmidt, M. I; Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Porto Alegre. BR
  • Couper, D; University of North Carolina. School of Public Health at Chapel Hill. Department of Biostatistics. Chapel Hill. US
  • Heiss, G; University of North Carolina. School of Public Health at Chapel Hill. Department of Epidemiology. Chapel Hill. US
  • Pankow, J. S; University of Minnesota. School of Public Health. Division of Epidemiology. Minneapolis. US
  • Ballantyne, C. M; Baylor College of Medicine. Department of Medicine. Houston. US
Braz. j. med. biol. res ; 40(7): 933-941, July 2007. tab, graf
Article Dans Anglais | LILACS | ID: lil-455996
ABSTRACT
To efficiently examine the association of glutamic acid decarboxylase antibody (GADA) positivity with the onset and progression of diabetes in middle-aged adults, we performed a case-cohort study representing the ~9-year experience of 10,275 Atherosclerosis Risk in Communities Study participants, initially aged 45-64 years. Antibodies to glutamic acid decarboxylase (GAD65) were measured by radioimmunoassay in 580 incident diabetes cases and 544 non-cases. The overall weighted prevalence of GADA positivity (³1 U/mL) was 7.3 percent. Baseline risk factors, with the exception of smoking and interleukin-6 (P ú 0.02), were generally similar between GADA-positive and -negative individuals. GADA positivity did not predict incident diabetes in multiply adjusted (HR = 1.04; 95 percentCI = 0.55, 1.96) proportional hazard analyses. However, a small non-significant adjusted risk (HR = 1.29; 95 percentCI = 0.58, 2.88) was seen for those in the highest tertile (³2.38 U/mL) of positivity. GADA-positive and GADA-negative non-diabetic individuals had similar risk profiles for diabetes, with central obesity and elevated inflammation markers, aside from glucose, being the main predictors. Among diabetes cases at study's end, progression to insulin treatment increased monotonically as a function of baseline GADA level. Overall, being GADA positive increased risk of progression to insulin use almost 10 times (HR = 9.9; 95 percentCI = 3.4, 28.5). In conclusion, in initially non-diabetic middle-aged adults, GADA positivity did not increase diabetes risk, and the overall baseline profile of risk factors was similar for positive and negative individuals. Among middle-aged adults, with the possible exception of those with the highest GADA levels, autoimmune pathophysiology reflected by GADA may become clinically relevant only after diabetes onset.
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Texte intégral: Disponible Indice: LILAS (Amériques) Sujet Principal: Autoanticorps / Diabète / Glutamate decarboxylase Type d'étude: Etude d'étiologie / Etude d'incidence / Étude observationnelle / Étude pronostique / Facteurs de risque Limites du sujet: Femelle / Humains / Mâle langue: Anglais Texte intégral: Braz. j. med. biol. res Thème du journal: Biologie / Médicament Année: 2007 Type: Article / Congrès et conférence / descriptif de projet Pays d'affiliation: Brésil / États-Unis d'Amérique Institution/Pays d'affiliation: Baylor College of Medicine/US / Universidade Federal do Rio Grande do Sul/BR / University of Minnesota/US / University of North Carolina/US

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Texte intégral: Disponible Indice: LILAS (Amériques) Sujet Principal: Autoanticorps / Diabète / Glutamate decarboxylase Type d'étude: Etude d'étiologie / Etude d'incidence / Étude observationnelle / Étude pronostique / Facteurs de risque Limites du sujet: Femelle / Humains / Mâle langue: Anglais Texte intégral: Braz. j. med. biol. res Thème du journal: Biologie / Médicament Année: 2007 Type: Article / Congrès et conférence / descriptif de projet Pays d'affiliation: Brésil / États-Unis d'Amérique Institution/Pays d'affiliation: Baylor College of Medicine/US / Universidade Federal do Rio Grande do Sul/BR / University of Minnesota/US / University of North Carolina/US