HLA typing and immunological characterization of young-onset diabetes mellitus in a Hong Kong Chinese population

M. A. Kelly, J. C N Chan, J. Heward, C. H. Mijovic, P. Z. Zimmet, V. T F Yeung, C. Cockram, A. H. Barnett

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Aims: A study of the Hong Kong Chinese showed that the majority of subjects with young-onset diabetes (age of diagnosis < 35 years) present with a phenotype suggestive of Type 2 diabetes mellitus, although up to 50% subsequently need insulin treatment. The aim of this study was to use a combination of clinical, genetic and immunological markers to characterize the disease phenotype further in such individuals and to determine whether the requirement for insulin is the result of autoimmune disease. Methods: One hundred and thirty-seven Hong Kong Chinese with young-onset diabetes were studied, irrespective of their mode of presentation. The subjects were typed for alleles of the HLA-DR and -DQ genes and investigated for the presence of autoantibodies to glutamic acid decarboxylase (GAD). Plasma C-peptide concentration and requirement for insulin were also determined. Results: One hundred and three subjects presented with a syndrome resembling Type 2 diabetes, while 34 presented with Type 1 diabetes. Of the former group, 35 patients (34.0%) were insulin-deficient, 16 (15.5%) were insulin-treated and seven (6.9%) were positive for GAD autoantibodies. Among the GAD-positive subjects presenting with Type 2 diabetes, the HLA-DRB1*03 allele may be a marker of early progression to insulin therapy. Conclusions: Seven subjects with Type 2 diabetes at presentation had autoantibodies to GAD. Causes other than GAD autoimmunity, however, must be sought to explain the high prevalence of insulin deficiency observed in the Chinese patients. This study highlights the heterogeneity of the pathogenic processes leading to the diabetic phenotype.

LanguageEnglish
Pages22-28
Number of pages7
JournalDiabetic Medicine
Volume18
Issue number1
DOIs
Publication statusPublished - 27 Feb 2001

Keywords

  • Disease phenotype
  • GAD autoantibodies
  • HLA genes
  • Hong Kong Chinese
  • Young-onset diabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Kelly, M. A., Chan, J. C. N., Heward, J., Mijovic, C. H., Zimmet, P. Z., Yeung, V. T. F., ... Barnett, A. H. (2001). HLA typing and immunological characterization of young-onset diabetes mellitus in a Hong Kong Chinese population. Diabetic Medicine, 18(1), 22-28. https://doi.org/10.1046/j.1464-5491.2001.00400.x
Kelly, M. A. ; Chan, J. C N ; Heward, J. ; Mijovic, C. H. ; Zimmet, P. Z. ; Yeung, V. T F ; Cockram, C. ; Barnett, A. H. / HLA typing and immunological characterization of young-onset diabetes mellitus in a Hong Kong Chinese population. In: Diabetic Medicine. 2001 ; Vol. 18, No. 1. pp. 22-28.
@article{3f84a46294cf401da7a66c7ed05b32ae,
title = "HLA typing and immunological characterization of young-onset diabetes mellitus in a Hong Kong Chinese population",
abstract = "Aims: A study of the Hong Kong Chinese showed that the majority of subjects with young-onset diabetes (age of diagnosis < 35 years) present with a phenotype suggestive of Type 2 diabetes mellitus, although up to 50{\%} subsequently need insulin treatment. The aim of this study was to use a combination of clinical, genetic and immunological markers to characterize the disease phenotype further in such individuals and to determine whether the requirement for insulin is the result of autoimmune disease. Methods: One hundred and thirty-seven Hong Kong Chinese with young-onset diabetes were studied, irrespective of their mode of presentation. The subjects were typed for alleles of the HLA-DR and -DQ genes and investigated for the presence of autoantibodies to glutamic acid decarboxylase (GAD). Plasma C-peptide concentration and requirement for insulin were also determined. Results: One hundred and three subjects presented with a syndrome resembling Type 2 diabetes, while 34 presented with Type 1 diabetes. Of the former group, 35 patients (34.0{\%}) were insulin-deficient, 16 (15.5{\%}) were insulin-treated and seven (6.9{\%}) were positive for GAD autoantibodies. Among the GAD-positive subjects presenting with Type 2 diabetes, the HLA-DRB1*03 allele may be a marker of early progression to insulin therapy. Conclusions: Seven subjects with Type 2 diabetes at presentation had autoantibodies to GAD. Causes other than GAD autoimmunity, however, must be sought to explain the high prevalence of insulin deficiency observed in the Chinese patients. This study highlights the heterogeneity of the pathogenic processes leading to the diabetic phenotype.",
keywords = "Disease phenotype, GAD autoantibodies, HLA genes, Hong Kong Chinese, Young-onset diabetes",
author = "Kelly, {M. A.} and Chan, {J. C N} and J. Heward and Mijovic, {C. H.} and Zimmet, {P. Z.} and Yeung, {V. T F} and C. Cockram and Barnett, {A. H.}",
year = "2001",
month = "2",
day = "27",
doi = "10.1046/j.1464-5491.2001.00400.x",
language = "English",
volume = "18",
pages = "22--28",
journal = "Diabetic Medicine",
issn = "0742-3071",
publisher = "Wiley-Blackwell",
number = "1",

}

Kelly, MA, Chan, JCN, Heward, J, Mijovic, CH, Zimmet, PZ, Yeung, VTF, Cockram, C & Barnett, AH 2001, 'HLA typing and immunological characterization of young-onset diabetes mellitus in a Hong Kong Chinese population', Diabetic Medicine, vol. 18, no. 1, pp. 22-28. https://doi.org/10.1046/j.1464-5491.2001.00400.x

HLA typing and immunological characterization of young-onset diabetes mellitus in a Hong Kong Chinese population. / Kelly, M. A.; Chan, J. C N; Heward, J.; Mijovic, C. H.; Zimmet, P. Z.; Yeung, V. T F; Cockram, C.; Barnett, A. H.

In: Diabetic Medicine, Vol. 18, No. 1, 27.02.2001, p. 22-28.

Research output: Contribution to journalArticle

TY - JOUR

T1 - HLA typing and immunological characterization of young-onset diabetes mellitus in a Hong Kong Chinese population

AU - Kelly, M. A.

AU - Chan, J. C N

AU - Heward, J.

AU - Mijovic, C. H.

AU - Zimmet, P. Z.

AU - Yeung, V. T F

AU - Cockram, C.

AU - Barnett, A. H.

PY - 2001/2/27

Y1 - 2001/2/27

N2 - Aims: A study of the Hong Kong Chinese showed that the majority of subjects with young-onset diabetes (age of diagnosis < 35 years) present with a phenotype suggestive of Type 2 diabetes mellitus, although up to 50% subsequently need insulin treatment. The aim of this study was to use a combination of clinical, genetic and immunological markers to characterize the disease phenotype further in such individuals and to determine whether the requirement for insulin is the result of autoimmune disease. Methods: One hundred and thirty-seven Hong Kong Chinese with young-onset diabetes were studied, irrespective of their mode of presentation. The subjects were typed for alleles of the HLA-DR and -DQ genes and investigated for the presence of autoantibodies to glutamic acid decarboxylase (GAD). Plasma C-peptide concentration and requirement for insulin were also determined. Results: One hundred and three subjects presented with a syndrome resembling Type 2 diabetes, while 34 presented with Type 1 diabetes. Of the former group, 35 patients (34.0%) were insulin-deficient, 16 (15.5%) were insulin-treated and seven (6.9%) were positive for GAD autoantibodies. Among the GAD-positive subjects presenting with Type 2 diabetes, the HLA-DRB1*03 allele may be a marker of early progression to insulin therapy. Conclusions: Seven subjects with Type 2 diabetes at presentation had autoantibodies to GAD. Causes other than GAD autoimmunity, however, must be sought to explain the high prevalence of insulin deficiency observed in the Chinese patients. This study highlights the heterogeneity of the pathogenic processes leading to the diabetic phenotype.

AB - Aims: A study of the Hong Kong Chinese showed that the majority of subjects with young-onset diabetes (age of diagnosis < 35 years) present with a phenotype suggestive of Type 2 diabetes mellitus, although up to 50% subsequently need insulin treatment. The aim of this study was to use a combination of clinical, genetic and immunological markers to characterize the disease phenotype further in such individuals and to determine whether the requirement for insulin is the result of autoimmune disease. Methods: One hundred and thirty-seven Hong Kong Chinese with young-onset diabetes were studied, irrespective of their mode of presentation. The subjects were typed for alleles of the HLA-DR and -DQ genes and investigated for the presence of autoantibodies to glutamic acid decarboxylase (GAD). Plasma C-peptide concentration and requirement for insulin were also determined. Results: One hundred and three subjects presented with a syndrome resembling Type 2 diabetes, while 34 presented with Type 1 diabetes. Of the former group, 35 patients (34.0%) were insulin-deficient, 16 (15.5%) were insulin-treated and seven (6.9%) were positive for GAD autoantibodies. Among the GAD-positive subjects presenting with Type 2 diabetes, the HLA-DRB1*03 allele may be a marker of early progression to insulin therapy. Conclusions: Seven subjects with Type 2 diabetes at presentation had autoantibodies to GAD. Causes other than GAD autoimmunity, however, must be sought to explain the high prevalence of insulin deficiency observed in the Chinese patients. This study highlights the heterogeneity of the pathogenic processes leading to the diabetic phenotype.

KW - Disease phenotype

KW - GAD autoantibodies

KW - HLA genes

KW - Hong Kong Chinese

KW - Young-onset diabetes

UR - http://www.scopus.com/inward/record.url?scp=0035133457&partnerID=8YFLogxK

U2 - 10.1046/j.1464-5491.2001.00400.x

DO - 10.1046/j.1464-5491.2001.00400.x

M3 - Article

VL - 18

SP - 22

EP - 28

JO - Diabetic Medicine

T2 - Diabetic Medicine

JF - Diabetic Medicine

SN - 0742-3071

IS - 1

ER -