Antibodies to glutamic acid decarboxylase in young Chinese diabetic patients

Gary T.C. Ko, Juliana C.N. Chan, Vincent T.F. Yeung, Chun Chung Chow, June K.Y. Li, Maggie S.W. Lau, Ian R. Mackay, Merrill J. Rowley, Paul Zimmet, Clive S. Cockram

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33 Citations (Scopus)

Abstract

Antibodies to glutamic acid decarboxylase (GAD) are a useful autoimmune marker for type 1 diabetes mellitus in Caucasians. We examined antibodies to GAD and their relationships with clinical features and pancreatic β cell function in 140 young Chinese diabetic patients. Over an 18-month period beginning in 1995, 140 young Chinese diabetic subjects with age of onset of disease ≤ 35 years and age < 40 years were recruited consecutively, irrespective of their modes of presentation. Clinical features, antibodies to GAD and pancreatic β cell function (using a glucagon stimulation test) were examined. Increased levels of antibodies to GAD (> 18 units) were detected in 12.1% (n = 17) of these subjects. Forty-three (31%) patients had a classical type 1 presentation and 65 (46%) patients were insulin-deficient based on post-glucagon plasma C-peptide levels. Patients who were insulin-deficient and had a type 1 presentation had the highest prevalence of antibodies to GAD (29.0%) compared with patients who had a type 2 presentation and were non-insulin deficient (6.4%, P = 0.003). Patients who had antibodies to GAD had lower body mass index and waist-hip ratio, earlier onset of disease, lower blood pressure, plasma triglyceride and C-peptide, and higher concentrations of plasma high-density lipoprotein cholesterol and glycated haemoglobin, and were more likely to require drug treatment, compared with those without antibodies to GAD. In conclusion, there was a low prevalence of antibodies to GAD in Chinese young diabetic patients although such antibodies remained a relatively specific marker for insulin deficiency and acute presentation. Causes other than autoimmunity should be sought to explain the high prevalence of insulin deficiency in these young Chinese patients.

Original languageEnglish
Pages (from-to)761-767
Number of pages7
JournalAnnals of Clinical Biochemistry
Volume35
Issue number6
DOIs
Publication statusPublished or Issued - 1998

Keywords

  • C-peptide
  • Glucagon stimulation test
  • Insulin

ASJC Scopus subject areas

  • Clinical Biochemistry

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