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© Georg Thieme Verlag Stuttgart · New York
Newly Diagnosed Latent Autoimmune Diabetes in Adults (LADA) is Associated with Low Level Glutamate Decarboxylase (GAD65) and IA-2 Autoantibodies* The co-authors ofthe DISS group are: Hans J. Arnqvist, Department of Internal Medicine, University of Linköping, Linköping; Elisabeth Björk, Department of Medicine, University Hospital Uppsala, Uppsala; Göran Blohmé, Department of Medicine, Sahlgrenska University Hospital, Gothenburg; Jan Bolinder, Center for Metabolism and Endocrinology, Huddinge University Hospital, Stockholm; Jan Eriksson and Folke Lithner, Department of Medicine, Umeå University Hospital, Umeå; Bengt Littorin, Department of Community Health Sciences, Lund; Lennarth Nyström, Department of Epidemiology and Public Health, University of Umeå, UmeŽ; Bengt Scherstén, Department of Community Health Sciences, Lund University, Lund; Lars Wibell, Department of Medicine, University Hospital Uppsala, Uppsala; Göran Sundkvist, Department of Endocrinology, Malmö; University Hospital, Malmö; and Jan Östman, Center for Metabolism and Endocrinology, Huddinge University Hospital, Stockholm, Sweden.
19 April 2007 (online)
A quantitative assay with microSepharose was used to determine GAD65Ab and IA-2Ab levels in 771 population-based patients diagnosed with diabetes mellitus at 15 to 34 years of age, and in 828 matched controls. Among the patients, 587 (76%) were classified with type I, 108 (14%) with type II, and 76 (10%) with unclassifiable diabetes. The levels above normal demonstrated a prevalence of GAD65Ab in 66% of type I diabetes, 50% of type II diabetes and 54% of unclassifiable patients and for IA-2Ab in 40%, 17% and 21%, respectively. Among the autoantibody-positive sera, the LADA patients had a lower GAD65Ab index (median 0.19, p < 0.0001) and IA-2Ab index (median 0.28, p < 0.0001) than the type I patients (median 0.37 and 0.66). Patients with unclassifiable diabetes had a GAD65Ab (median 0.43) or IA-2Ab (median 0.63) index which was not different from the type I diabetes patients. Our data demonstrate that young adult new-onset LADA patients have low level GAD65Ab and IA-2Ab. The low-level autoantibodies may signify a less aggressive beta-cell autoimmunity, which may explain why these patients are often classified with type II or non-insulin-dependent diabetes.
Autoimmunity - Diabetes Mellitus - Islet Cell Autoantibodies - Type I Diabetes - Type II Diabetes - ROC Curve