Anti-GAD antibodies in Chinese patients with youth and adult-onset IDDM and NIDDM |
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Authors: | A C Thai W Y Ng K Y Loke W R W Lee K F Lui J S Cheah |
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Institution: | (1) Department of Medicine, National University of Singapore, Republic of Singapore, SG;(2) Department of Paediatrics, National University of Singapore, Republic of Singapore, SG;(3) Department of Paediatrics, Singapore General Hospital, Republic of Singapore, SG |
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Abstract: | Summary An autoimmune basis for the pathogenesis of insulin-dependent diabetes mellitus (IDDM) is supported by the frequent presence
of autoantibodies – islet cell antibodies (ICAs) and GAD antibodies (GADab). However, in Chinese patients with clinical IDDM,
a low prevalence of ICAs was observed. In non-insulin-dependent diabetic (NIDDM) patients, it has been suggested that the
presence of GADab may identify a subset of latent autoimmune diabetes in adults (LADA). We determined the frequency of GADab
in a large group of 134 IDDM and 168 NIDDM Chinese patients, and assessed the relation with ICAs status. Results showed that
39.6 % IDDM and 16.1 % NIDDM patients had GADab, and 20.1 % and 4.8 %, respectively had detectable ICAs. Frequency of GADab
positivity was not influenced by whether the patients had youth or adult-onset IDDM or NIDDM, or by duration of diabetes.
NIDDM patients seropositive for GADab shared similar clinical characteristics and fasting C-peptide levels with those who
were GADab negative. Presence of GADab therefore did not serve to identify a sub-group of patients with latent or slow-onset
IDDM. Half (53 %) of our IDDM patients had neither GADab nor ICAs. The reason for this observation is unclear. One theory
is that other autoantigens yet to be identified may be contributory. Alternatively, in the Chinese, autoimmunity may not be
the major factor in the pathogenesis of IDDM. Diabetologia (1997) 40: 1425–1430]
Received: 11 March 1997 and in revised form: 13 May 1997 |
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Keywords: | GAD antibodies islet cell antibodies IDDM NIDDM Chinese |
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