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

AbstractAIMS:
This study investigated the association between glutamic acid decarboxylase antibodies (GAD-AB) and Type 1, Type 2, pancreatic and lipoatrophic diabetes mellitus (DM) in South African patients.
METHODS:
Four groups were selected: group A, 100 Black Type 1 DM patients (age at onset < 35 years, body mass index (BMI) < 27 kg/m2 and insulin dependent within 1 year of presentation); group B, 80 Black Type 2 DM patients (age at onset > 35 years, BMI > 27 kg/m2 and controlled on oral hypoglycaemic agents for at least 1 year after presentation); group C, 10 patients of varying ethnicity with DM or impaired glucose tolerance secondary to chronic pancreatitis; group D, five patients of varying ethnicity with DM associated with total lipodystrophy. Fifty healthy Black control subjects were also studied (group E). Serum GAD-AB and random C-peptide levels were measured by radioimmunoassay.
RESULTS:
Mean C-peptide concentration was significantly lower in Type 1 DM patients than Type 2 DM patients (P < 0.00001). Forty-four patients with Type 1 DM were GAD-AB-positive compared to two patients with Type 2 DM. Two control subjects were also GAD-AB-positive. No patient in the other groups had a titre > 1 U/ml. Type 1 DM patients who were GAD-AB-positive did not differ 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.
AuthorsV R Panz, W J Kalk, M Zouvanis, B I Joffe
JournalDiabetic medicine : a journal of the British Diabetic Association (Diabet Med) Vol. 17 Issue 7 Pg. 524-7 (Jul 2000) ISSN: 0742-3071 [Print] England
PMID10972582 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Autoantibodies
  • C-Peptide
  • Glutamate Decarboxylase
Topics
  • Adult
  • Autoantibodies (immunology)
  • Black People
  • C-Peptide (blood)
  • Diabetes Mellitus (blood, classification, immunology)
  • Diabetes Mellitus, Type 1 (blood, immunology)
  • Diabetes Mellitus, Type 2 (blood, immunology)
  • Female
  • Glutamate Decarboxylase (immunology)
  • Humans
  • Male
  • Middle Aged
  • Pancreatic Diseases (blood, immunology)
  • Radioimmunoassay
  • South Africa

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