Autoantibodies to multiple islet autoantigens in patients with abrupt onset type 1 diabetes and diabetes diagnosed with urinary glucose screening

被引:46
作者
Sera, Y
Kawasaki, E
Abiru, N
Ozaki, M
Abe, T
Takino, H
Kondo, H
Yamasaki, H
Yamaguchi, Y
Akazawa, S
Nagataki, S
Uchigata, Y
Matsuura, N
Eguchi, K
机构
[1] Nagasaki Univ, Sch Med, Dept Internal Med 1, Nagasaki 8528501, Japan
[2] Radiat Effects Res Fdn, Hiroshima 7320815, Japan
[3] Tokyo Womens Med Coll, Ctr Diabet, Tokyo 1628666, Japan
[4] Kitazato Univ, Sch Med, Dept Pediat, Kanagawa 2288555, Japan
关键词
autoimmunity; heterogeneity; ICA512; GAD; insulin;
D O I
10.1006/jaut.1999.0315
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
It has been reported that there is a heterogeneity in the clinical course of Japanese patients with type 1 diabetes. To elucidate the associations of expression of autoantibodies to multiple islet antigens with age of onset and mode of diagnosis of diabetes in Japanese patients with type 1 diabetes, autoantibodies against the protein tyrosine phosphatase-like molecules ICA512 (IA-2) and phogrin (IA-2 beta) (ICA512/phogrin-A), GAD (GADA), insulin (IAA), and islet cell cytoplasm (ICA) were determined in sera from 73 Japanese patients with type 1 diabetes obtained within 14 days of diagnosis. Patients were divided into groups based on the age of onset (less than or equal to 10 years, n = 24 and >10 years, n = 49) or the mode of onset (abrupt onset, n = 59 and urinary screening identified, n = 14)1 Of 73 new-onset patients with type 1 diabetes, 43 (59%) and 32 (44%) had ICA512A and phogrin-A levels exceeding the 99th percentile of 184 normal control subjects, respectively. Forty-five patients (62%) were positive for either ICA512A or phogrin-A. The frequencies for other autoantibodies were 71% for GADA, 48% for IAA, and 62% for ICA. The frequency of ICA512/phogrin-A was significantly higher in patients with an age of onset less than 10 years (83%) than in patients aged >10 years (51%, P<0.01). The positivity of ICA512/phogrin-A was less in patients whose diabetes was diagnosed by the urine glucose screening test (21%, P<0.001) than in abrupt onset patients (71%). Combined analysis (greater than or equal to 1 antibody) of GADA, IAA, and ICA512/phogrin-A detected 88% of abrupt onset and 93% of screening-positive patients vs. 70% and 29%, respectively, for ICA (P<0.0005). These results indicate that the expression of ICA512/phogrin-A and cytoplasmic ICA is less in patients identified by urinary glucose testing but indicate that with combined autoantibody testing 90% of patients can be identified independent of the mode of diagnosis. (C) 1999 Academic Press.
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页码:257 / 265
页数:9
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