Glutamate decarboxylase antibody levels predict rate of beta-cell decline in adult-onset diabetes

Diabetes Res Clin Pract. 1995 Feb;27(2):133-40. doi: 10.1016/0168-8227(95)01026-a.

Abstract

Glutamate decarboxylase autoantibodies (GAD65Ab) and beta-cell function were evaluated at and 3 years after diabetes onset in consecutive subjects over 15 years of age. At onset, 21/32 (66%) insulin-treated patients (mean age 43, range 16-79 years) had GAD65Ab; all GAD65Ab persisted 3 years later. At onset, 20/82 (24%) non-insulin-treated patients (mean age 56, range 20-79 years) had GAD65Ab. Of those with persistent GAD65Ab, 8 non-insulin-treated and 11 insulin-treated patients consented to follow-up glucose and glucagon stimulation tests. For non-insulin-treated patients, quantitative GAD65Ab index at onset correlated inversely with 1 + 3 min C-peptide response to glucose (r = -0.68, P < 0.05) and to glucagon (r = -0.79, P < 0.05) 3 years later. Those with high (> 0.50) initial GAD65Ab index had lower C-peptide (fasting, 1 + 3 min after glucose and after glucagon) 3 years later, versus those with low (< 0.50) initial GAD65Ab index (P < 0.05). In conclusion, not only did GAD65Ab presence predict future insulin dependence, but higher GAD65Ab levels may mark more rapid decline in beta-cell function in apparent non-insulin-dependent diabetes.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Analysis of Variance
  • Autoantibodies / blood*
  • Biomarkers / blood
  • Chi-Square Distribution
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / immunology
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / immunology
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Glutamate Decarboxylase / immunology*
  • Glycated Hemoglobin A / analysis
  • Humans
  • Islets of Langerhans / pathology
  • Islets of Langerhans / physiopathology*
  • Middle Aged
  • Predictive Value of Tests
  • Recombinant Proteins / immunology
  • Statistics, Nonparametric

Substances

  • Autoantibodies
  • Biomarkers
  • Glycated Hemoglobin A
  • Recombinant Proteins
  • Glutamate Decarboxylase