DIAGNOSTIC-SIGNIFICANCE OF ANTIBODIES TO GLUTAMIC-ACID DECARBOXYLASE IN JAPANESE DIABETIC-PATIENTS WITH SECONDARY ORAL HYPOGLYCEMIC AGENTS FAILURE

Citation
M. Fukui et al., DIAGNOSTIC-SIGNIFICANCE OF ANTIBODIES TO GLUTAMIC-ACID DECARBOXYLASE IN JAPANESE DIABETIC-PATIENTS WITH SECONDARY ORAL HYPOGLYCEMIC AGENTS FAILURE, Clinical immunology and immunopathology, 85(2), 1997, pp. 182-186
Citations number
25
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Pathology,Immunology
ISSN journal
0090-1229
Volume
85
Issue
2
Year of publication
1997
Pages
182 - 186
Database
ISI
SICI code
0090-1229(1997)85:2<182:DOATGD>2.0.ZU;2-G
Abstract
Some non-insulin-dependent diabetes mellitus (NIDDM) patients are posi tive for antibodies to glutamic acid decarboxylase (anti-GAD), and the y tend to develop insulin deficiency. The aim of this study was to eva luate the prevalence of anti-GAD in NIDDM with secondary failure of su lfonylurea agents (NIDDM-SF) and to investigate the diagnostic signifi cance of seropositivity for anti-GAD in NIDDM-SF patients by evaluatin g human leukocyte antigen (HLA)-DRB1 alleles concurrently, The prevale nce of anti-GAD in NIDDM-SF, NIDDM, and new-onset (within 1 year after onset) insulin-dependent diabetes mellitus (IDDM) was 9.3% (39/420), 3.1% (12/392), and 65.0% (13/20), respectively, Pancreatic beta cell f unction deteriorated in NIDDM-SF patients positive for anti-GAD. HLA-D RB1 allele typing revealed that NIDDM-SF patients positive for anti-GA D were significantly associated with DRB1()0901 (RR = 2.81, P < 0.01) , which is one of the susceptible alleles to IDDM. Shorter interval be fore development of secondary failure and insulin deficiency were sign ificantly associated with the presence of DRB1()0901 (P < 0.05) in NI DDM-SF patients positive for anti-GAD, In conclusion, nearly 10% of NI DDM-SF patients are positive for anti-GAD, suggesting that an autoimmu ne mechanism might play an important role in the pathogenesis of NIDDM -SF patients, In addition, a combination of serological marker (anti-G AD) and genetic marker (HLA-DRB1) is useful for predicting clinical co urse of NIDDM patients with secondary failure of sulfonylurea agents. (C) 1997 Academic Press.