Immunogenetic and nutritional profile in insulin-using youth-onset diabetics in Korea.
There are few reports on the genetic, immunological and nutritional characteristics of insulin-using youth-onset diabetes mellitus, insulin-dependent diabetes mellitus (IDDM) and malnutrition-related diabetes mellitus (MRDM) in Korea. Among 1266 hospitalized Korean diabetics, 29 (2.3%) were IDDM and 84 (6.6%) were MRDM. A diabetes history of first-relatives (28.6%) was more frequently found in the MRDM group than in the IDDM (14.8) and non-insulin-dependent diabetes mellitus (NIDDM) (19.0%) groups. HLA-DR4 was more common among IDDM (54.2%) and MRDM (52.4%) patients than controls (26.3%), and HLA-DR3 was more common among only IDDM patients (29.2%) than controls (10.9%). Conventional islet-cell antibodies were detected in 8 of 15 IDDM patients tested (53.3%) and in 11 of 22 MRDM patients (50.0%). MRDM patients had higher serum basal (1.02 +/- 0.51 ng/ml) and peak (1.44 +/- 0.76 ng/ml) C-peptide concentrations than IDDM patients, but lower concentrations than NIDDM patients. Before the onset of diabetes, the calorie intake of 21 MRDM patients assessed was 63.1% of the daily requirement and the intake of carbohydrate, protein and fat was 71.7%, 55.9% and 39.8%, respectively. In summary, our data suggest that IDDM in Korea is associated with HLA-DR3 or HLA-DR4, indicating a risk for IDDM in Western societies; furthermore, MRDM has a history of undernutrition at the preonset period and is also associated with HLA-DR4. It might be also concluded that MRDM in Korea is another expression of IDDM caused by the shortage of some nutrients for the structural and/or functional maintenance of pancreatic beta-cells.
Huh
K B
KB
Department of Internal Medicine, Yonsei University, Seoul, Korea.
Lee
H C
HC
Kim
H M
HM
Cho
Y W
YW
Kim
Y L
YL
Lee
K W
KW
Lee
E J
EJ
Lim
S K
SK
Kim
D H
DH
Yoon
J W
JW
D000293:Adolescent; D001323:Autoantibodies / Q000032:analysis; D001786:Blood Glucose / Q000378:metabolism; D001798:Blood Proteins / Q000032:analysis; D002096:C-Peptide / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D003920:Diabetes Mellitus / Q000209:etiology / Q000276:immunology / Q000503:physiopathology*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000276:immunology / Q000503:physiopathology*; D004032:Diet; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis; D006684:HLA-DR Antigens / Q000032:analysis*; D006801:Humans; D007515:Islets of Langerhans / Q000276:immunology; D007723:Korea; D008297:Male; D009748:Nutrition Disorders / Q000150:complications*; D014280:Triglycerides / Q000097:blood; D014815:Vitamins
D001323:Autoantibodies; D001786:Blood Glucose; D001798:Blood Proteins; D002096:C-Peptide; D008076:Cholesterol, HDL; D006442:Glycated Hemoglobin; D006684:HLA-DR Antigens; D014280:Triglycerides; D014815:Vitamins; C024211:islet cell antibody