title: Differential association of HLA with three subtypes of type 1 diabetes: fulminant, slowly progressive and acute-onset.
abstract: OBJECTIVE
  We sought to clarify similarities and differences in the contribution of HLA to genetic susceptibility to three subtypes of type 1 diabetes: acute-onset, fulminant and slowly progressive.
  
  
  METHODS
  We genotyped 545 Japanese patients with type 1 diabetes (338 acute-onset, 80 fulminant, 127 slowly progressive) and 396 control participants at HLA-DRB1, -DQB1, -A, -B and -C, and at 101 candidate single nucleotide polymorphisms (SNPs) in an 8.5 Mb region of the extended HLA.
  
  
  RESULTS
  DRB1*0405-DQB1*0401, DRB1*0802-DQB1*0302 and DRB1*0901-DQB1*0303 were associated with acute-onset type 1 diabetes, with the DRB1*0405-DQB1*0401/DRB1*0802-DQB1*0302 genotype achieving the highest odds ratio of 42.7. DRB1*1501-DQB1*0602 and DRB1*1502-DQB1*0601 were negatively associated with acute-onset type 1 diabetes. A similar tendency was observed for slowly progressive type 1 diabetes. In contrast, only DRB1*0405-DQB1*0401 was associated with fulminant type 1 diabetes, with the DRB1*0405-DQB1*0401/DRB1*0405-DQB1*0401 genotype showing the highest odds ratio of 11.2. DRB1*0802-DQB1*0302, DRB1*0405-DQB1*0401/DRB1*0802-DQB1*0302 and DRB1*1501-DQB1*0602 were not associated with fulminant type 1 diabetes. The association of class I alleles and a panel of SNPs in an extended HLA region with fulminant type 1 diabetes was also different from that seen for the acute-onset and slowly progressive forms. The presence of both one and two susceptible haplotypes conferred susceptibility to slowly progressive type 1 diabetes, whereas the presence of two susceptible haplotypes was required to confer susceptibility to acute-onset and fulminant type 1 diabetes.
  
  
  CONCLUSIONS
  These data suggest that HLA associations with fulminant type 1 diabetes are qualitatively different from those with other subtypes of type 1 diabetes, whereas the HLA contribution to slowly progressive type 1 diabetes is qualitatively similar to, but quantitatively different from, that in acute-onset type 1 diabetes.
authors.affiliation: Department of Endocrinology, Metabolism and Diabetes, Kinki University School of Medicine, 377-2 Ohno-higashi, Osaka-sayama, Osaka, 589-8511, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kawabata
authors.forename: H
authors.initials: H
authors.lastname: Ikegami
authors.forename: T
authors.initials: T
authors.lastname: Awata
authors.forename: A
authors.initials: A
authors.lastname: Imagawa
authors.forename: T
authors.initials: T
authors.lastname: Maruyama
authors.forename: E
authors.initials: E
authors.lastname: Kawasaki
authors.forename: S
authors.initials: S
authors.lastname: Tanaka
authors.forename: A
authors.initials: A
authors.lastname: Shimada
authors.forename: H
authors.initials: H
authors.lastname: Osawa
authors.forename: T
authors.initials: T
authors.lastname: Kobayashi
authors.forename: T
authors.initials: T
authors.lastname: Hanafusa
authors.forename: K
authors.initials: K
authors.lastname: Tokunaga
authors.forename: H
authors.initials: H
authors.lastname: Makino
mesh_terms: D003922:Diabetes Mellitus, Type 1 / Q000235:genetics* / Q000276:immunology* / Q000503:physiopathology / Q000517:prevention & control; D018450:Disease Progression; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006680:HLA Antigens / Q000235:genetics*; D006683:HLA-DQ Antigens / Q000235:genetics; D059866:HLA-DQ beta-Chains; D006684:HLA-DR Antigens / Q000235:genetics; D059811:HLA-DRB1 Chains; D015395:Histocompatibility Antigens Class I / Q000235:genetics; D000949:Histocompatibility Antigens Class II / Q000235:genetics; D006801:Humans; D007438:Introns / Q000235:genetics; D007564:Japan; D011401:Promoter Regions, Genetic / Q000235:genetics; D012016:Reference Values
chemical_list: D006680:HLA Antigens; D006683:HLA-DQ Antigens; D059866:HLA-DQ beta-Chains; C069051:HLA-DQB1 antigen; D006684:HLA-DR Antigens; D059811:HLA-DRB1 Chains; D015395:Histocompatibility Antigens Class I; D000949:Histocompatibility Antigens Class II