Adult-onset type 1 diabetic patients with less severe clinical manifestation have less risk DR-DQ genotypes than childhood-onset patients

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Background: The aim of this study was to investigate differences in clinical features and HLA genotypes between adult-onset and childhood-onset patients with type 1 diabetes in a Chinese population. Materials and Methods: This study enrolled 716 Han Chinese patients with type 1 diabetes from Guangdong (258 childhood-onset and 458 adult-onset) to compare their clinical features. Of them 214 patients with classical type 1 diabetes (100 childhood-onset and 114 adult-onset) were selected for HLA DR and DQ genotyping by next-generation sequencing. Results: Adult-onset patients were characterized by longer duration of symptoms before diagnosis, lower frequency of DKA at disease onset, less frequent autoantibody positivity, higher serum C-peptide concentrations, and better glycemic control. These findings were replicated in the restricted cohort of 214 patients with classical type 1 diabetes. Compared with childhood-onset patients, adult-onset patients had a lower frequency of the DR9 haplotype, as well as lower frequency of high-risk DR3/DR4 and DR3/DR9 genotypes, but higher frequency of DR3/DR3 genotype and DR3/X, DR4/X or DR9/X (X, non-risk) genotypes. Conclusions: Adult-onset type 1 diabetic patients with susceptible haplotypes (DR3, DR4 or DR9) were more likely to carry protective DR-DQ haplotypes than childhood-onset patients, which suggested the association between less risk DR-DQ genotypes and the less severe clinical manifestation in adult-onset patients.


  • Wenqian Ren
  • Daizhi Yang
  • Ziyu Jiang
  • Yingxin Xian
  • Qianwen Huang
  • Sihui Luo
  • Xueying Zheng
  • Jinhua Yan
  • Wen Xu
  • Bin Yao
  • Cong Yi Wang
  • Jin Xin Bei
  • Leif Groop
  • Janelle A. Noble
  • Jianping Weng
External organisations
  • University of Science and Technology of China
  • Huazhong University of Science and Technology
  • Children's Hospital Oakland Research Institute
  • Sun Yat-sen University
  • Skåne University Hospital
  • Third Affiliated Hospital of Sun Yat‐sen University
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Endocrinology and Diabetes


  • adult onset diabetes, age of diabetes onset, clinical characteristics, genetics, HLA typing, type 1 diabetes
Original languageEnglish
JournalDiabetes/Metabolism Research and Reviews
Issue number1
Early online date2020 May 28
Publication statusPublished - 2021
Publication categoryResearch