Glutamic acid decarboxylase and islet antigen 2 antibody profiles in people with adult-onset diabetes mellitus: a comparison between mixed ethnic populations in Singapore and Germany.

Abstract

AIM:

To gain insight into the presence of islet cell autoimmunity in an ethnic Asian compared with a white European population.

METHODS:

For this cross-sectional study we recruited people with adult-onset diabetes (age of diagnosis 20-60 years), at tertiary referral centres in Germany (n=1020) and Singapore (n=1088). Glutamic acid decarboxylase and islet antigen 2 antibodies were measured according to Islet Autoantibody Standardization Program protocols.

RESULTS:

The prevalence of glutamic acid decarboxylase antibody positivity was 13.9% (95% CI 12.1-16.0; P<0.001) in the white European cohort compared with 6.8% (95% CI 5.5-8.4; P<0.001) in the Asian cohort. Glutamic acid decarboxylase antibody positivity was 11.4% (95% CI 7.7-16.6) in Indian, 6.0% (95% CI 3.6-9.9) in Malay and 5.8% (95% CI 4.3-7.7; P<0.001) in Chinese participants. In the white European participants, the prevalence of islet antigen 2 antibody positivity was 7.8% (95% CI 6.4-9.4) compared with 14.8% (95% CI 12.8-17.0; P<0.001) in the Asian cohort as a whole, and among the three ethnicities in the Asian cohort it was 12.4% (95% CI 8.6-17.7) in Indian, 16.8% (95% CI 12.6-22.2) in Malay and 15.7% (95% CI 13.2-18.6) in Chinese participants. Double antibody positivity was seen in 5.7% (95% CI 4.5-7.1) of white European participants compared with 1.6% (95% CI 1.0-2.5; P<0.01) of Asian participants. In the white European cohort, those who were glutamic acid decarboxylase autoantibody-positive had a lower BMI than those who were autoantibody-negative, but this trend was absent in the Asian cohort.

CONCLUSIONS:

A marked prevalence of islet cell autoimmunity was observed in people with adult-onset diabetes. While glutamic acid decarboxylase antibodies were more frequent in the European cohort, islet antigen 2 antibody positivity was highest in the three ethnic groups in Singapore, suggesting ethnic-specific differences in antibody profiles.

• Authors: Y H Ong, W C A Koh, M L Ng, Z Y Tam, S C Lim, B O Boehm, Adult-Onset Autoimmune Diabetes Mellitus Consortium (ADAMS)
• Journal: Diabetic medicine : a journal of the British Diabetic Association (Diabet Med) Vol. 34 Issue 8 Pg. 1145-1153 (08 2017) ISSN: 1464-5491 [Electronic] England
• PMID: 28370329 (Publication Type: Comparative Study, Journal Article)
• Copyright: © 2017 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.

Chemical References

• Autoantibodies
• Biomarkers
• PTPRN protein, human
• Receptor-Like Protein Tyrosine Phosphatases, Class 8
• Glutamate Decarboxylase

Topics

• Adult
• Asian People
• Autoantibodies (analysis)
• Autoimmune Diseases (blood, epidemiology, ethnology, immunology)
• Autoimmunity
• Biomarkers (blood)
• Cohort Studies
• Cross-Sectional Studies
• Diabetes Mellitus, Type 2 (blood, epidemiology, ethnology, immunology)
• Germany (epidemiology)
• Glutamate Decarboxylase (antagonists & inhibitors)
• Humans
• Male
• Middle Aged
• Prevalence
• Receptor-Like Protein Tyrosine Phosphatases, Class 8 (antagonists & inhibitors)
• Referral and Consultation
• Singapore (epidemiology)
• Tertiary Care Centers
• White People
• Young Adult