Distribution of autoantibodies to glutamic acid decarboxylase across the spectrum of diabetes mellitus seen in South Africa

Citation
Vr. Panz et al., Distribution of autoantibodies to glutamic acid decarboxylase across the spectrum of diabetes mellitus seen in South Africa, DIABET MED, 17(7), 2000, pp. 524-527
Citations number
21
Categorie Soggetti
Endocrynology, Metabolism & Nutrition
Journal title
DIABETIC MEDICINE
ISSN journal
07423071 → ACNP
Volume
17
Issue
7
Year of publication
2000
Pages
524 - 527
Database
ISI
SICI code
0742-3071(200007)17:7<524:DOATGA>2.0.ZU;2-G
Abstract
Aims This study investigated the association between glutamic acid decarbox ylase antibodies (GAD-AB) and Type 1, Type 2, pancreatic and lipoatrophic d iabetes mellitus (DM) in South African patients. Methods Four groups were selected: group A, 100 Black Type 1 DM patients (a ge at onset < 35 years, body mass index (BMI) < 27 kg/m(2) and insulin depe ndent within 1 year of presentation); group B, 80 Black Type 2 DM patients (age at onset > 35 years, BMI > 27 kg/m(2) and controlled on oral hypoglyca emic agents for at least 1 year after presentation); group C, 10 patients o f varying ethnicity with DM or impaired glucose tolerance secondary to chro nic pancreatitis; group D, five patients of varying ethnicity with DM assoc iated with total lipodystrophy. Fifty healthy Black control subjects were a lso studied (group E). Serum GAD-AB and random C-peptide levels were measur ed by radioimmunoassay. Results Mean C-peptide concentration was significantly lower in Type 1 DM p atients than Type 2 DM patients (P < 0.00001). Forty-four patients with Typ e 1 DM were GAD-AB-positive compared to two patients with Type 2 DM. Two co ntrol subjects were also GAD-AB-positive. No patient in the other groups ha d a titre > 1 U/ml. Type 1 DM patients who were GAD-AB-positive did not dif fer from those who were GAD-AB-negative for age at onset, duration of DM or C-peptide concentrations. Conclusions Auto-immune beta-cell destruction has an important role in the pathogenesis of Type 1 DM amongst African patients. However, Type 2 African DM patients and other diabetes subtypes are largely GAD-AB-negative.