title: Anti-thyroid peroxidase antibody, IA-2 antibody, and fasting C-peptide levels predict beta cell failure in patients with latent autoimmune diabetes in adults (LADA)--a 5-year follow-up of the Ehime study.
abstract: OBJECTIVE
  To clarify the natural course and factors involved in beta cell failure in Japanese latent autoimmune diabetes in adults (LADA) patients.
  
  
  METHODS
  Insulin secretion in 57 LADA patients identified from among 4980 adult-onset diabetic patients in a hospital-based Ehime study were examined over a 5-year period. Postprandial serum C-peptide levels below 0.33 nmol/l were defined as beta cell failure. The involvement of clinical and immunological factors in the progression to beta cell failure were evaluated.
  
  
  RESULTS
  Forty-two of the fifty-seven LADA patients completed the 5-year follow-up. Eleven (26.2%) required insulin treatment and five (11.9%) progressed to beta cell failure. A Cox regression analysis revealed that positive anti-thyroid peroxidase antibody (TPOAb) and insulinoma-associated protein 2 (IA-2Ab) were associated with the need for insulin treatment (p<0.05 and p<0.01, respectively). Positive TPOAb, anti-thyroglobulin antibody (TGAb), IA-2 antibody (p<0.01 for each), and lower serum fasting C-peptide levels (p<0.05) were contributors to the progression to beta cell failure. Involvement of type 1 diabetes susceptible HLA class II genes was not evident.
  
  
  CONCLUSIONS
  Japanese LADA patients are a heterogeneous population. In addition to IA-2 antibody, presence of TPOAb and fasting C-peptide level could indicate an oncoming deterioration of beta cell function.
authors.affiliation: Matsuyama Shimin Hospital, Ehime, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Murao
authors.forename: Shiori
authors.initials: S
authors.lastname: Kondo
authors.forename: Jun
authors.initials: J
authors.lastname: Ohashi
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Fujii
authors.forename: Ikki
authors.initials: I
authors.lastname: Shimizu
authors.forename: Masao
authors.initials: M
authors.lastname: Fujiyama
authors.forename: Keizo
authors.initials: K
authors.lastname: Ohno
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Takada
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Nakai
authors.forename: Yukio
authors.initials: Y
authors.lastname: Yamane
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Osawa
authors.forename: Hideichi
authors.initials: H
authors.lastname: Makino
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People / Q000235:genetics / Q000706:statistics & numerical data; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood*; D002096:C-Peptide / Q000097:blood*; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology* / Q000235:genetics / Q000276:immunology*; D005260:Female; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease / Q000453:epidemiology; D006683:HLA-DQ Antigens / Q000235:genetics; D059866:HLA-DQ beta-Chains; D006684:HLA-DR Antigens / Q000235:genetics; D059811:HLA-DRB1 Chains; D006239:Haplotypes; D006801:Humans; D007328:Insulin / Q000378:metabolism; D000078790:Insulin Secretion; D050417:Insulin-Secreting Cells / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D007453:Iodide Peroxidase / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D002096:C-Peptide; D006683:HLA-DQ Antigens; D059866:HLA-DQ beta-Chains; C069051:HLA-DQB1 antigen; D006684:HLA-DR Antigens; D059811:HLA-DRB1 Chains; C096322:ICA512 autoantibody; D007328:Insulin; D007453:Iodide Peroxidase