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Åke Lernmark

Principal investigator

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High diagnostic sensitivity of glutamate decarboxylase autoantibodies in insulin-dependent diabetes mellitus with clinical onset between age 20 and 40 years

Author

  • Christina L. Vandewalle
  • Alberto Falorni
  • Sigrun Svanholm
  • Åke Lernmark
  • Daniel G. Pipeleers
  • Frans K. Gorus

Summary, in English

Patients with adult-onset Type 1 (insulin-dependent) diabetes mellitus (IDDM) are more difficult to identify than young patients, as their clinical onset is often less acute with a questionable state of insulin dependency. Classification may be facilitated by the detection of autoantibodies that are associated with IDDM. The prevalence of islet cell autoantibodies (ICA) and insulin autoantibodies (IAA) is, however, markedly lower in adult than in young patients. The present study assesses the usefulness of antibodies against glutamate decarboxylase (GAD), as a complementary marker. Sera from 312 recent-onset IDDM patients under age 40 and 163 age-matched controls were assayed for IAA, ICA, and antibodies against recombinant GAD65 (Mr 65,000) or GAD67 (Mr 67,000). IAA or ICA occurred in over 90% of patients diagnosed under age 20 but only in 65% of patients between age 20 and 40. Determination of GAD65-Ab did not increase the percent antibody positive patients under age 10, but did so at older ages: from 92–98% in the 10–19 years age group, and from 65–85% in the 20–39 years age group. The determination of GAD67-Ab did not add to the information provided by the GAD65-Ab assay. Our results indicate that, alone or in combination with ICA, the GAD65-Ab assay identified more patients with an IDDM marker in the age group 20–39 years than in the group under age 20.

Publishing year

1995-01-01

Language

English

Pages

846-851

Publication/Series

Journal of Clinical Endocrinology and Metabolism

Volume

80

Issue

3

Document type

Journal article

Publisher

Oxford University Press

Status

Published

ISBN/ISSN/Other

  • ISSN: 0021-972X