Correlation between residual beta-cell function and islet cell antibodies in newly diagnosed type I diabetes. Follow-up study.
To establish whether there is a correlation between the autoimmune response to the islets and beta-cell function during the initial stages of type I (insulin-dependent) diabetes, and islet cell antibody (ICA) titer and C-peptide levels (fasting and glucagon stimulated) were determined in 39 newly diagnosed patients at onset of diabetes and every 3-6 mo for 2 yr. ICAs were detected in 74% of the patients, and beta-cell function was detected in 84% of the patients at onset. The ICA+ and ICA- groups had similar C-peptide values at diagnosis and at 3 mo, but from 6 mo on, the ICA+ group consistently showed a tendency to lose C-peptide secretory capacity more quickly when assessed by fasting and glucagon-stimulated C-peptide levels (ICA+ vs. ICA- fasting C-peptide levels at 18 and 24 mo, P = .013 and .017, respectively; ICA+ vs. ICA- glucagon-stimulated C-peptide levels at 6, 18, and 24 mo, P = .023, .007, and .028, respectively). The initial ICA titer had the highest predictive value on the outcome of beta-cell function (P = .04), and patients with complement-fixing ICAs did not behave differently from the general ICA+ group. This correlation between beta-cell function and ICA titer supports the role of autoimmunity in the pathogenesis of type I diabetes and has important implications for the design of immunotherapy trials.
Peig
M
M
Endocrinology and Diabetes Unit, Hospital Clinic, University of Barcelona, Spain.
Gomis
R
R
Ercilla
G
G
Casamitjana
R
R
Bottazzo
G F
GF
Pujol-Borrell
R
R
D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000032:analysis*; D002096:C-Peptide / Q000032:analysis; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000209:etiology / Q000276:immunology* / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D005934:Glucagon / Q000494:pharmacology; D006801:Humans; D007328:Insulin / Q000378:metabolism; D000078790:Insulin Secretion; D007515:Islets of Langerhans / Q000276:immunology* / Q000502:physiology; D008297:Male; D010295:Parietal Cells, Gastric / Q000276:immunology; D013961:Thyroid Gland / Q000276:immunology
D001323:Autoantibodies; D002096:C-Peptide; D007328:Insulin; D005934:Glucagon