title: Islet autoimmunity status in Asians with young-onset diabetes (12-40 years): association with clinical characteristics, beta cell function and cardio-metabolic risk factors.
abstract: In this paper, the islet autoimmunity status and relation to clinical characteristics, beta cell function and cardio-metabolic risk factors in young-onset Asian diabetic patients are evaluated at baseline. The study population consisted of 912 patients (from China, India, Malaysia and Singapore) with age 12-40 years and diabetes duration <12 months. Autoantibodies to glutamic acid decarboxylase (GADA) and tyrosine phosphatase (IA-2A), beta cell function and cardio-metabolic risk parameters were assessed. Among our young patient cohort, 105 (11.5%) patients were GADA and/or IA-2A positives (Ab +ve). Ab +ve patients were younger, leaner, had more severe hyperglycaemia and lower beta cell function. The frequency of metabolic syndrome was significantly lower in Ab +ve patients (27%) compared to Ab -ve patients (54%). However, a substantial proportion of patients in both groups of patients had atherogenic dyslipidaemia, hypertension and albuminuria (micro or macro). In our study cohort, only one in 10 Asian youth with new-onset diabetes had evidence of islet autoimmunity. At least 60% of Ab +ve and 50% of Ab -ve patients demonstrated classical features of type 1 and type 2 diabetes respectively. Regardless of autoimmunity status, the cardio-metabolic risk factors, in particular atherogenic dyslipidaemia, hypertension and albuminuria were common in our patients with young-onset diabetes.
authors.affiliation: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 5 Lower Kent Ridge Road, 119074 Singapore, Singapore.
authors.forename: A C
authors.initials: AC
authors.lastname: Thai
authors.forename: V
authors.initials: V
authors.lastname: Mohan
authors.forename: B A K
authors.initials: BA
authors.lastname: Khalid
authors.forename: C S
authors.initials: CS
authors.lastname: Cockram
authors.forename: C Y
authors.initials: CY
authors.lastname: Pan
authors.forename: P
authors.initials: P
authors.lastname: Zimmet
authors.forename: J P
authors.initials: JP
authors.lastname: Yeo
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D044466:Asian People / Q000208:ethnology; D001315:Australia; D015551:Autoimmunity; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000276:immunology*; D005260:Female; D005968:Glutamate Decarboxylase / Q000276:immunology; D006801:Humans; D007515:Islets of Langerhans / Q000201:enzymology / Q000276:immunology*; D008297:Male; D017027:Protein Tyrosine Phosphatases / Q000276:immunology; D012307:Risk Factors
chemical_list: D017027:Protein Tyrosine Phosphatases; D005968:Glutamate Decarboxylase