title: Clinical and biochemical characteristics of nonobese type 2 diabetic patients with glutamic acid decarboxylase antibody in Korea.
abstract: 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.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Yongdong Severance Hospital, College of Medicine, Yonsei University, Kangnam-ku, Seoul 135-720, Korea.
authors.forename: Chul Sik
authors.initials: CS
authors.lastname: Kim
authors.forename: Jae Hyun
authors.initials: JH
authors.lastname: Nam
authors.forename: Ji Sun
authors.initials: JS
authors.lastname: Nam
authors.forename: Jong Suk
authors.initials: JS
authors.lastname: Park
authors.forename: Eun Seok
authors.initials: ES
authors.lastname: Kang
authors.forename: Chul Woo
authors.initials: CW
authors.lastname: Ahn
authors.forename: Bong Soo
authors.initials: BS
authors.lastname: Cha
authors.forename: Sung Kil
authors.initials: SK
authors.lastname: Lim
authors.forename: Kyung Rae
authors.initials: KR
authors.lastname: Kim
authors.forename: Hyun Chul
authors.initials: HC
authors.lastname: Lee
authors.forename: Kap Bum
authors.initials: KB
authors.lastname: Huh
mesh_terms: 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
chemical_list: D001323:Autoantibodies; D002096:C-Peptide; D007004:Hypoglycemic Agents; D007328:Insulin; D005968:Glutamate Decarboxylase