Abstract
The presence or absence of islet cell autoantibodies is one of the most direct ways to distinguish between type 1 and 2 diabetic patients. The objective of the present study was to assess the prevalence of β-cell autoantibodies such as glutamic acid decarboxylase-65 antibodies (GADAs) and islet cell antibodies (ICA) among patients younger than 20 years of age with recently diagnosed diabetes in northwest of Iran. From 2006 to 2008, 163 patients were enrolled in this study. They were clinically classified into two groups: 136 with type 1 diabetes (T1D) and 27 with type 2 diabetes (T2D). Serum levels of GADAs, ICA and C-peptide were determined with enzyme linked immunosorbent assay (ELISA) kits. Fasting blood glucose and HbA1c levels were also determined. Chi-square test, independent t test and one-way analysis of variance were used for data analysis. The prevalence of GADAs in T1D patients was 33.1%, slightly lower than that of ICA 35.3%. Forty-eight patients (35.3%) with T1D were positive for ICA compared to only one (3.7%) in T2D patients. The overall occurrence of any autoantibody in T1D patients (60.3%) was significantly higher than that of T2D patients (18.5%) (P < 0.001). There was a statistically different association with family history of diabetes among the autoantibody positive versus autoantibody negative patients with T1D (P < 0.01). Our results confirmed the presence of GADAs and ICA in T1D patients in Iran, though roughly at a lower prevalence than that reported for Caucasian T1D patients, but very similar to other non-Caucasian ethnic populations.
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References
Atkinson MA, Eisenbarth GS. Type 1 diabetes: new perspectives on disease pathogenesis and treatment. Lancet. 2001;358:221–9.
Kobayashi T, Tamemoto K, Nakanishi K. Immunogenetic and clinical characterization of slowly progressive IDDM. Diab Care. 1993;16:780–8.
Baekkeskov S, Aanstoot HJ, Christgau S, Reetz A, Solimena M, Cascalho M, et al. Identification of the 64 K autoantigen in insulin-dependent diabetes as the GABA-synthesizing enzyme glutamic acid decarboxylase. Nature. 1990;347:151–6.
Winter WE, Harris N, Schatz D. Type 1 diabetes islet autoantibody markers. Diab Technol Ther. 2002;4:817–39.
American Diabetes Association. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diab Care. 2003;26 Suppl 1:S5–20.
Bingley PJ, Bonifacio E, Williams AJ, Genovese S, Bottazzo GF, Gale EA. Prediction of IDDM in the general population: strategies based on combinations of autoantibody markers. Diabetes. 1997;46:1701–10.
Gorus FK, Goubert P, Semakula C, Vandewalle CL, De Schepper J, Scheen A, et al. IA-2- autoantibodies complement GAD65-autoantibodies in new-onset IDDM patients and help predict impending diabetes in their siblings. The Belgian diabetes registry. Diabetologia. 1997;40:95–9.
Hagopian WA, Sanjeevi CB, Kockum I, Landin-Olsson M, Karlsen AE, Sundkvist G, et al. Glutamate decarboxylase-, insulin- and islet cell-antibodies and HLA typing to detect diabetes in a general population-based study of Swedish children. J Clin Invest. 1995;95:1501–11.
Turner R, Stratton I, Horton V, Manley S, Zimmet P, Mackay IR, et al. UKPDS 25: autoantibodies to islet-cell cytoplasm and glutamic acid decarboxylase for prediction of insulin requirement in type 2 diabetes. UK prospective diabetes study group. Lancet. 1997;350:1288–93.
Van Deutekom AW, Heine RJ, Simsek S. The islet autoantibody titres: their clinical relevance in latent autoimmune diabetes in adults (LADA) and the classification of diabetes mellitus. Diabet Med. 2008;25:117–25.
Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med. 1998;15:539–53.
Unnikrishnan AG, Bhatia E, Bhatia V, Bhadada SK, Sahay RK, Kannan A, et al. Type 1 diabetes versus type 2 diabetes with onset in persons younger than 20 years of age. Ann NY Acad Sci. 2008;1150:239–44.
Damanhouri LH, Dromey JA, Christie MR, Nasrat HA, Ardawi MS, Robins RA, et al. Autoantibodies to GAD and IA-2 in Saudi Arabian diabetic patients. Diabet Med. 2005;22:448–52.
Wan Nazaimoon WM, Faridah I, Singaraveloo M, Ismail IS, Wan Mohamad WB, Letchuman R, et al. Prevalence of glutamic acid decarboxylase antibodies amongst young Malaysian diabetics. ; 1999;43:59–66.
Lutale JJK, Thordarson H, Holm PJ, Eide GE, Vetvik K. Islet cell autoantibodies in African patients with type 1 and type 2 diabetes in Dar es Salaam Tanzania: a cross sectional study. J Autoimmune Dis. 2007;4:4–10.
Taplin CE, Barker JM. Autoantibodies in type 1 diabetes. Autoimmunity. 2008;41:11–8.
Imagawa A, Itoh N, Hanafusa T, Katsura H, Yamaguchi A, Takeda A, et al. High prevalence of antibodies to glutamic acid decarboxylase in comparison to islet cell antibodies in patients with long-standing insulin-dependent diabetes mellitus. Res Commun Mol Pathol Pharmacol. 1996;92:43–52.
Kupila A, Muona P, Simell T, Arvilommi P, Savolainen H, Hamalainen AM, et al. Feasibility of genetic and immunological prediction of type I diabetes in a population-based birth cohort. Diabetologia. 2001;44:290–7.
Niskanen LK, Tuomi T, Karjalainen J, Groop LC, Uusitupa MI. GAD antibodies in NIDDM. Ten-year follow-up from the diagnosis. Diab Care. 1995;18:1557–65.
Tung YC, Chen MH, Lee CT, Tsai WY. β-cell autoantibodies and their function in Taiwanese children with type 1 diabetes mellitus. J Formos Med Assoc. 2009;108:856–61.
Notsu K, Oka N, Note S, Nabeya N, Kuno S, Sakurami T. Islet cell antibodies in the Japanese population and subjects with type 1 (insulin-dependent) diabetes. Diabetologia. 1985;28:660–2.
Park Y, EIisenbarth GS. Genetic susceptibility factors of type 1 diabetes in Asians and their functional evaluation. Diab Metab Res Rev. 2001;17:2–11.
Park Y, Lee H, Takino H, Abiru N, Kawasaki E, Eisenbarth GS. Evaluation of the efficacy of multiple autoantibody screening in Korean patients with IDDM. Acta Diabetol. 2001;38:51–66.
Omar MA, Bottazzo G, Asmal AC. Islet cell antibodies and other autoantibodies in South African blacks and Indians with insulin dependent diabetes mellitus (IDDM). Horm Metab Res. 1986;18:126–8.
Peters WH, Lester FT, Kohnert KD, Hildmann W. The frequency of islet cell surface antibodies in newly diagnosed diabetics from Ethiopia. Exp Clin Endocrinol. 1986;87:326–32.
Panz VR, Kalk WJ, Zouvanis M, Joffe BI. Distribution of autoantibodies to glutamic acid decarboxylase across the spectrum of diabetes mellitus seen in South Africa. Diabet Med. 2000;17:524–7.
Thunander M, Petersson C, Jonzon K, Fornander J, Ossiansson B, Torn C, et al. Incidence of type 1 and type 2 diabetes in adults and children in Kronoberg, Sweden. Diab Res Clin Pract. 2008;82:247–55.
Rapaport R, Silverstein JH, Garzarella L, Rosenbloom AL. Type 1 and type 2 diabetes mellitus in childhood in the United States: practice patterns by pediatric endocrinologists. J Pediatr Endocrinol Metab. 2004;17:871–7.
Pozzilli P, Guglielmi C, Pronina E, Petraikina E. Double or hybrid diabetes associated with an increase in type 1 and type 2 diabetes in children and youths. Pediatr Diab. 2007;9:88–95.
Wei Z, Wang K, Qu HQ, Zhang H, Bradfield J, Kim C, et al. From disease association to risk assessment: an optimistic view from genome-wide association studies on type 1 diabetes. PLoS Genet. 2009;5:1–11.
Aly TA, Ide A, Jahromi MM, Barker JM, Fernando MS, Babu SR, et al. Extreme genetic risk for type 1A diabetes. PNAS. 2006;103:14074–9.
Permutt MA, Wasson J, Cox N. Genetic epidemiology of diabetes. J Clin Invest. 2005;115:1431–9.
Gao P, Jiao Y, Xiong Q, Wang CY, Gerling I, Gu W. Genetic and molecular basis of QTL of diabetes in mouse: genes and polymorphisms. Curr Genomics. 2008;9:324–7.
Acknowledgement
We would like to thank Mr. Parvin for his assistance with sample collection and organising laboratory tests.
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This work is supported by a grant from the Research Deputy, Tabriz University of Medical Sciences, Tabriz, Iran
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Marandi, L.Y., Rajaii, M., Aliasgarzadeh, A. et al. Islet cell autoantibodies in patients younger than 20 years of age with recently diagnosed diabetes in Northwest of Iran. Int J Diabetes Dev Ctries 31, 70–75 (2011). https://doi.org/10.1007/s13410-011-0015-5
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DOI: https://doi.org/10.1007/s13410-011-0015-5