A 12-year prospective study of the relationship between islet antibodies and beta-cell function at and after the diagnosis in patients with adult-onset diabetes.

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Bibtex

@article{a94b1cfbe15644239b9439b9fd5b6bfe,
title = "A 12-year prospective study of the relationship between islet antibodies and beta-cell function at and after the diagnosis in patients with adult-onset diabetes.",
abstract = "To clarify the relationships between islet antibodies (islet cell antibody [ICA], GAD antibody [GADA], and IA-2 antibody [IA-2A]) versus the progression of beta-cell dysfunction, we have followed a group of diabetic patients from their diagnosis at 21-73 years of age. Patients with ICA had high levels of GADA and/or IA-2A at diagnosis and a more severe beta-cell dysfunction 5 years after diagnosis than those with only GADA in low concentrations. The aim of the current 12-year follow-up study was to examine the further progression of beta-cell dysfunction in relation to islet antibodies at and after diagnosis. Among 107 patients, complete beta-cell failure 12 years after diagnosis was restricted to those with islet antibodies at diagnosis (16 of 21 [77%] with multiple antibodies and 4 of 5 [80%] with only GADA). In contrast, among antibody-negative patients, fasting P-C-peptide levels were unchanged. Most GADA-positive patients (22 of 27 [81%]) remained GADA positive after 12 years. Associated with decreasing fasting P-C-peptide levels (0.85 nmol/l [0.84] at diagnosis vs. 0.51 nmol/l [0.21] 12 years after diagnosis, P < 0.05), ICA developed after diagnosis in 6 of 105 originally antibody negative mostly overweight patients. In conclusion, multiple islet antibodies or GADA alone at diagnosis of diabetes predict future complete beta-cell failure. After diagnosis, GADA persisted in most patients, whereas ICA development in patients who were antibody negative at diagnosis indicated decreasing beta-cell function.",
keywords = "Diabetes Mellitus, Islets of Langerhans : immunology, Human, Islets of Langerhans : physiopathology, Isoenzymes : immunology, Middle Age, Prognosis, Prospective Studies, Support, Non-U.S. Gov't, Glutamate Decarboxylase : immunology, Non-Insulin-Dependent : physiopathology, Fasting, Non-Insulin-Dependent : immunology, Non-Insulin-Dependent : diagnosis, Adult, Aged, Autoantibodies : blood, C-Peptide : blood",
author = "Henrik Borg and Anders Gotts{\"a}ter and Per Fernlund and G{\"o}ran Sundkvist",
note = "The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Endocrinology (013241500), Unit for Clinical Vascular Disease Research (013242410), Clinical Chemistry, Malm{\"o} (013016000), Pediatrics/Urology/Gynecology/Endocrinology (013240400)",
year = "2002",
doi = "10.2337/diabetes.51.6.1754",
language = "English",
volume = "51",
pages = "1754--1762",
journal = "Diabetes",
issn = "1939-327X",
publisher = "American Diabetes Association Inc.",
number = "6",

}