We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
The Presence of GAD and IA-2 Antibodies in Youth With a Type 2 Diabetes Phenotype.
- Authors
KLINGENSMITH, GEORGEANNA J.; PYLE, LAURA; ARSLANIAN, SILVA; COPELAND, KENNETH C.; CUTTLER, LEONA; KAUFMAN, FRANCINE; LAFFEL, LORI; MARCOVINA, SANTICA; TOLLEFSEN, SHERIDA E.; WEINSTOCK, RUTH S.; LINDER, BARBARA
- Abstract
OBJECTIVE -- To determine the frequency of islet cell autoimmunity in youth clinically diagnosed with type 2 diabetes and describe associated clinical and laboratory findings. RESEARCH DESIGN AND METHODS-- Children (10-17 years) diagnosed with type 2 diabetes were screened for participation in the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study. Measurements included GAD-65 and insulinoma-associated protein 2 autoantibodies using the new National Institute of Diabetes and Digestive and Kidney Diseases/National Institutes of Health (NIDDK/NIH) standardized assays, a physical examination, and fasting lipid, C-peptide, and A1C determinations. RESULTS -- Of the 1,206 subjects screened and considered clinically to have type 2 diabetes, 118 (9.8%) were antibody positive; of these, 71 (5.9%) were positive for a single antibody, and 47 were positive (3.9%) for both antibodies. Diabetes autoantibody (DAA) positivity was significantly associated with race (P < 0.0001), with positive subjects more likely to be white (40.7 vs. 19%) (P < 0.0001) and male (51.7 vs. 35.7%) (P = 0.0007). BMI, BMI z score, C-peptide, A1C, triglycerides, HDL cholesterol, and blood pressure were significantly different by antibody status. The antibody-positive subjects were less likely to display characteristics clinically associated with type 2 diabetes and a metabolic syndrome phenotype, although the range for BMI Z score, blood pressure, fasting C-peptide, and serum lipids overlapped between antibody-positive and antibody-negative subjects. CONCLUSIONS-- Obese youth with a °clinical diagnosis of type 2 diabetes may have evidence of islet autoimmunity contributing to insulin deficiency. As a group, patients with DAA have clinical characteristics significantly different from those without DAA. However, without islet autoantibody analysis, these characteristics cannot reliably distinguish between obese young individuals with type 2 diabetes and those with autoimmune diabetes.
- Subjects
ISLANDS of Langerhans; AUTOIMMUNITY; TYPE 2 diabetes; IMMUNOGLOBULINS; DIABETES in children
- Publication
Diabetes Care, 2010, Vol 33, Issue 9, p1970
- ISSN
0149-5992
- Publication type
Article
- DOI
10.2337/dc10-0373