title: Genetic susceptibility to non-insulin dependent diabetes mellitus and glucose intolerance are located in HLA region.
abstract: OBJECTIVE
  To test the hypothesis that the genetic susceptibility to non-insulin dependent diabetes mellitus is the same as that to insulin dependent disease and to see whether glucose intolerance is associated with specific HLA haplotypes.
  
  
  METHODS
  Population based study of men in 1989 first tested for glucose tolerance in 1984. HLA haplotypes, including HLA-A, C, B, DR, and DQ, were defined serologically. HLA haplotype data from a population based Finnish study of childhood diabetes were used for predicting non-insulin dependent diabetes and impaired glucose tolerance.
  
  
  METHODS
  Two communities in Finland.
  
  
  METHODS
  Representative cohort of Finnish men aged 70-89, comprising 98 men with non-insulin dependent diabetes mellitus and a randomly selected group of 74 men, who served as controls, who were tested for glucose tolerance twice within five years.
  
  
  METHODS
  Non-insulin dependent diabetes, impaired glucose tolerance, blood glucose concentration.
  
  
  RESULTS
  Diabetes associated HLA haplotypes were present in 94% (85/90) of diabetic subjects, 79% (27/34) of subjects with impaired glucose tolerance, and only 13% (3/23) of non-diabetic subjects. In this group of elderly men sensitivity of the diabetes associated HLA haplotypes for non-insulin dependent diabetes and impaired glucose tolerance was 90%, specificity 87%, and predictive power 97%. Mean fasting blood glucose concentration was only just significantly higher in men with diabetes associated haplotypes than in men with no such haplotypes, but there was a substantial difference in blood glucose values two hours after glucose loading (10.4 and 6.4 mmol/l in men with diabetes associated HLA haplotypes and men with no such haplotypes, respectively (p < 0.0001)).
  
  
  CONCLUSIONS
  These findings support the hypothesis that specific HLA haplotypes exhibit a common genetic determinant for insulin dependent and non-insulin dependent diabetes. Furthermore, HLA is a major genetic determinant of glucose intolerance in elderly Finnish men. The belief that the HLA predisposition to diabetes is specific for insulin dependent diabetes mellitus is largely incorrect.
authors.affiliation: Department of Epidemiology, National Public Health Institute, Helsinki, Finland.
authors.forename: E
authors.initials: E
authors.lastname: Tuomilehto-Wolf
authors.forename: J
authors.initials: J
authors.lastname: Tuomilehto
authors.forename: G A
authors.initials: GA
authors.lastname: Hitman
authors.forename: A
authors.initials: A
authors.lastname: Nissinen
authors.forename: J
authors.initials: J
authors.lastname: Stengård
authors.forename: J
authors.initials: J
authors.lastname: Pekkanen
authors.forename: P
authors.initials: P
authors.lastname: Kivinen
authors.forename: E
authors.initials: E
authors.lastname: Kaarsalo
authors.forename: M J
authors.initials: MJ
authors.lastname: Karvonen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis / Q000235:genetics; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology / Q000235:genetics*; D004198:Disease Susceptibility / Q000097:blood / Q000453:epidemiology; D005387:Finland / Q000453:epidemiology; D020022:Genetic Predisposition to Disease; D006680:HLA Antigens / Q000235:genetics*; D006239:Haplotypes / Q000235:genetics*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011897:Random Allocation
chemical_list: D001786:Blood Glucose; D006680:HLA Antigens