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Islet cell autoantibody levels after the diagnosis of young adult diabetic patients

Author:
  • R. Jensen
  • L. Gilliam
  • Carina Törn
  • Mona Landin-Olsson
  • J. Palmer
  • K. Akesson
  • I. Kockum
  • Barbro Lernmark
  • A. F. Karlsson
  • Kristian Lynch
  • N. Breslow
  • Åke Lernmark
  • Göran Sundkvist
Publishing year: 2007
Language: English
Pages: 1221-1228
Publication/Series: Diabetic Medicine
Volume: 24
Issue: 11
Document type: Journal article
Publisher: Wiley-Blackwell

Abstract english

Aims The aim was to determine the course of islet cell antibodies [glutamate decarboxylase (GADA), tyrosine phosphatase-like islet antigen 2 (IA-2A) and islet cell (ICA)] after the diagnosis of the diabetic patient. Methods The Diabetes Incidence Study in Sweden (DISS) attempted to prospectively enrol all newly diagnosed diabetic patients aged 15-34 years during 1992 and 1993. C-peptide and autoantibody levels were determined from venous blood samples at diagnosis and again at yearly intervals for 6 years. Results After the first year, the odds of remaining GADA positive decreased by 9% per year [odds ratio (OR) = 0.91, 95% confidence interval (CI) = 0.85-0.96] while the mean GADA index remained unchanged (chi(2)(1) = 0.8, P = 0.37). There was no change in the percentage of subjects testing IA-2A positive after the first year (chi(2)(1) = 0.1, P = 0.75). However, the mean index decreased 0.04 per year (95% CI: 0.03-0.05)-a 7.9% decline (95% CI: 5.4-10.4%). The odds of a subject testing positive for ICA decreased by 24% per year (OR = 0.76, 95% CI = 0.70-0.82). The mean ICA levels decreased 0.75 per year (95% CI: 0.66-0.84)-a 16.4% decline (95% CI: 14.1-18.6%). The rate of change in titres for all three autoantibodies was independent of gender, human leucocyte antigen genotype and C-peptide status. Conclusions GADA levels remained high while ICA levels declined. In contrast to a previous study, we found that the proportion of IA-2A subjects remaining positive did not decrease after the first year, while the average index decreased slightly.

Keywords

  • Endocrinology and Diabetes
  • tyrosine phosphatase-like islet antigen 2 antibodies
  • Type 1 diabetes
  • islet cell antibodies
  • C-peptide
  • glutamate decarboxylase antibodies

Other

Published
  • Diabetes and Celiac Unit
  • ISSN: 1464-5491
E-mail: ake [dot] lernmark [at] med [dot] lu [dot] se

Principal investigator

Diabetes and Celiac Unit

+46 40 39 19 01

+46 70 616 47 79

60:11:015

Jan Waldenströms gata 35, Malmö

33

Lund University Diabetes Centre, CRC, SUS Malmö, Jan Waldenströms gata 35, House 91:12. SE-214 28 Malmö. Telephone: +46 40 39 10 00