Clinical and biochemical characteristics of nonobese type 2 diabetic patients with glutamic acid decarboxylase antibody in Korea.
We evaluated the prevalence of glutamic acid decarboxylase autoantibody (GADA) in nonobese patients with type 2 diabetes mellitus in Korea and investigated the characteristics of GADA-positive and GADA-negative patients. Two years later, we assessed the progression of beta-cell function in these patients. Of the 647 nonobese patients with type 2 diabetes mellitus enrolled in the study, 10.1% was positive for GADA. Glutamic acid decarboxylase antibody-positive patients had lower fasting and stimulated C-peptide levels compared with GADA-negative patients (1.70 +/- 0.72 vs 1.24 +/- 0.59 microg/L, P < .001; 2.59 +/- 1.51 vs 1.99 +/- 0.82 microg/L, P < .001). Patients treated with insulin had lower fasting and stimulated C-peptide levels than those not treated (1.13 +/- 0.52 vs 1.66 +/- 0.73 microg/L, P = .002; 1.85 +/- 0.69 vs 2.49 +/- 0.91 microg/L, P = .004) and had higher titers of GADA (30.5 +/- 7.3 vs 6.0 +/- 4.8 U/mL, P < .001). In terms of progression of beta-cell function, fasting and stimulated C-peptide levels were significantly lower in GADA-positive patients after 2 years (from 1.24 +/- 0.59 to 0.95 +/- 0.54 microg/L, P = .004; from 1.99 +/- 0.82 to 1.61 +/- 0.77 microg/L, P = .007), whereas no such difference was observed in the GADA-negative patients. We demonstrate that a significant proportion of Korean patients may be positive for GADA; this is consistent with studies of white subjects, although disagrees with previous reports on Korean subjects. By assessing the presence of GADA in Korean type 2 diabetic patients, we are able to predict their course of beta-cell function and identify in advance those who are likely to require insulin treatment.
Kim
Chul Sik
CS
Division of Endocrinology and Metabolism, Department of Internal Medicine, Yongdong Severance Hospital, College of Medicine, Yonsei University, Kangnam-ku, Seoul 135-720, Korea.
Nam
Jae Hyun
JH
Nam
Ji Sun
JS
Park
Jong Suk
JS
Kang
Eun Seok
ES
Ahn
Chul Woo
CW
Cha
Bong Soo
BS
Lim
Sung Kil
SK
Kim
Kyung Rae
KR
Lee
Hyun Chul
HC
Huh
Kap Bum
KB
D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D001323:Autoantibodies / Q000032:analysis*; D015992:Body Mass Index; D002096:C-Peptide / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000201:enzymology / Q000453:epidemiology / Q000276:immunology*; D005260:Female; D005968:Glutamate Decarboxylase / Q000276:immunology*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged
D001323:Autoantibodies; D002096:C-Peptide; D007004:Hypoglycemic Agents; D007328:Insulin; D005968:Glutamate Decarboxylase