title: The heterogeneity of islet autoantibodies and the progression of islet failure in type 1 diabetic patients.
abstract: Type 1 diabetes mellitus is heterogeneous in many facets. The patients suffered from type 1 diabetes present several levels of islet function as well as variable number and type of islet-specific autoantibodies. This study was to investigate prevalence and heterogeneity of the islet autoantibodies and clinical phenotypes of type 1 diabetes mellitus; and also discussed the process of islet failure and its risk factors in Chinese type 1 diabetic patients. A total of 1,291 type 1 diabetic patients were enrolled in this study. Demographic information was collected. Laboratory tests including mixed-meal tolerance test, human leukocyte antigen alleles, hemoglobinA1c, lipids, thyroid function and islet autoantibodies were conducted. The frequency of islet-specific autoantibody in newly diagnosed T1DM patients (duration shorter than half year) was 73% in East China. According to binary logistic regressions, autoantibody positivity, longer duration and lower Body Mass Index were the risk factors of islet failure. As the disease developed, autoantibodies against glutamic acid decarboxylase declined as well as the other two autoantibodies against zinc transporter 8 and islet antigen 2. The decrease of autoantibodies was positively correlated with aggressive beta cell destruction. Autoantibodies can facilitate the identification of classic T1DM from other subtypes and predict the progression of islet failure. As there were obvious heterogeneity in autoantibodies and clinical manifestation in different phenotypes of the disease, we should take more factors into consideration when identifying type 1 diabetes mellitus.
authors.affiliation: Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
authors.forename: Jin
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authors.lastname: Liu
authors.affiliation: Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
authors.forename: Lingling
authors.initials: L
authors.lastname: Bian
authors.affiliation: Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
authors.forename: Li
authors.initials: L
authors.lastname: Ji
authors.affiliation: Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
authors.forename: Heng
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Gu
authors.affiliation: Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
authors.forename: Bingqin
authors.initials: B
authors.lastname: Ma
authors.affiliation: Department of Endocrinology and Metabolism, Nanjing Children's Hospital, Nanjing, 210008, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Gu
authors.affiliation: Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
authors.forename: Xinyu
authors.initials: X
authors.lastname: Xu
authors.affiliation: Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Shi
authors.affiliation: Department of Endocrinology and Metabolism, Nanjing General Hospital of Nanjing Military Command, Nanjing, 210002, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Endocrinology and Metabolism, Nanjing Drum Tower Hospital The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
authors.forename: Dalong
authors.initials: D
authors.lastname: Zhu
authors.affiliation: Department of Endocrinology and Metabolism, Zhongda Hospital Southeast University, Nanjing, 210009, China.
authors.forename: Zilin
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authors.lastname: Sun
authors.affiliation: Department of Endocrinology and Metabolism, Nanjing First Hospital, Nanjing, 210000, China.
authors.forename: Jianhua
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authors.lastname: Ma
authors.affiliation: Department of Endocrinology and Metabolism, Zhongda Hospital Southeast University, Nanjing, 210009, China.
authors.forename: Hui
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authors.lastname: Jin
authors.affiliation: Department of Endocrinology and Metabolism, Nanjing Children's Hospital, Nanjing, 210008, China.
authors.forename: Xing
authors.initials: X
authors.lastname: Shi
authors.affiliation: Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, 210011, China.
authors.forename: Heng
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authors.lastname: Miao
authors.affiliation: Department of Endocrinology and Metabolism, Nanjing Governmental Hospital, Nanjing, 210008, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Xin
authors.affiliation: Department of Endocrinology and Metabolism, Northern Jiangsu People's Hospital, Yangzhou, 225001, China.
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authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Department of Endocrinology and Metabolism, Northern Jiangsu People's Hospital, Yangzhou, 225001, China.
authors.forename: Zhenwen
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authors.lastname: Zhang
authors.affiliation: Department of Endocrinology and Metabolism, Wuxi People's Hospital, Wuxi, 214023, China.
authors.forename: Ruifang
authors.initials: R
authors.lastname: Bu
authors.affiliation: Department of Endocrinology and Metabolism, Wuxi People's Hospital, Wuxi, 214023, China.
authors.forename: Lan
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authors.affiliation: Department of Endocrinology and Metabolism, Jiangsu Jiangyin People's Hospital, Wuxi, 214400, China.
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authors.affiliation: Department of Endocrinology and Metabolism, Jiangsu Jiangyin People's Hospital, Wuxi, 214400, China.
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authors.affiliation: Department of Endocrinology and Metabolism, The Affiliated Hospital of Xuzhou Medical College, Xuzhou, 221006, China.
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authors.affiliation: Department of Endocrinology and Metabolism, The Affiliated Hospital of Xuzhou Medical College, Xuzhou, 221006, China.
authors.forename: Dongmei
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authors.affiliation: Department of Endocrinology and Metabolism, Xuzhou Central Hospital, Xuzhou, 221009, China.
authors.forename: Jun
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authors.affiliation: Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China.
authors.forename: Xingbo
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authors.affiliation: Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China.
authors.forename: Bimin
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authors.affiliation: Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China.
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authors.affiliation: Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China.
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authors.affiliation: Department of Endocrinology and Metabolism, The First People's Hospital of Kunshan, Suzhou, 215300, China.
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authors.affiliation: Department of Endocrinology and Metabolism, Huai'an Second People's Hospital, Huai'an, 223002, China.
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authors.affiliation: Department of Endocrinology and Metabolism, Huai'an First People's Hospital, Huai'an, 223300, China.
authors.forename: Weiping
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authors.affiliation: Department of Endocrinology and Metabolism, The First People's Hospital of Zhenjiang, Zhenjiang, 212002, China.
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authors.affiliation: Department of Endocrinology and Metabolism, The First People's Hospital of Zhenjiang, Zhenjiang, 212002, China.
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authors.affiliation: Department of Endocrinology and Metabolism, Jiangsu Taizhou People's Hospital, Taizhou, 225300, China.
authors.forename: Jialin
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authors.affiliation: Department of Endocrinology and Metabolism, Jiangsu Taizhou People's Hospital, Taizhou, 225300, China.
authors.forename: Xiaoqiang
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authors.affiliation: Department of Endocrinology and Metabolism, Jiangsu Taizhou People's Hospital, Taizhou, 225300, China.
authors.forename: Qingqing
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authors.affiliation: Department of Endocrinology and Metabolism, The First People's Hospital of Nantong, Nantong, 226000, China.
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authors.affiliation: Department of Endocrinology and Metabolism, Affiliated Hospital of Nantong University, Nantong, 226001, China.
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authors.affiliation: Department of Endocrinology and Metabolism, Wuhu No.2 People's Hospital, Wuhu, 241000, China.
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authors.affiliation: Department of Endocrinology and Metabolism, Wuhu No.2 People's Hospital, Wuhu, 241000, China.
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authors.affiliation: Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
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authors.affiliation: Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
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authors.affiliation: Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
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authors.affiliation: Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
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authors.affiliation: Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
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authors.affiliation: Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
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authors.affiliation: Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
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authors.affiliation: Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
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authors.affiliation: Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Jin
authors.affiliation: Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
authors.forename: Zheng
authors.initials: Z
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authors.affiliation: Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
authors.forename: Kuanfeng
authors.initials: K
authors.lastname: Xu
authors.affiliation: Department of Isotopic Laboratory of Nanjing Medical University, Nanjing, 210000, China.
authors.forename: Yifan
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authors.lastname: Li
authors.affiliation: HLA Laboratory of Jiangsu Province People's Hospital, Nanjing, 210029, China.
authors.forename: Jie
authors.initials: J
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authors.affiliation: Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
authors.forename: Hongwen
authors.initials: H
authors.lastname: Zhou
authors.affiliation: Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
authors.forename: Wei
authors.initials: W
authors.lastname: He
authors.affiliation: Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
authors.forename: Xuqin
authors.initials: X
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authors.affiliation: Key Laboratory of Human Functional Genomics of Jiangsu Province, Nanjing Medical University, Nanjing, 210000, China.
authors.forename: Xiao
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authors.affiliation: Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, Aurora, Colorado, 80045, USA.
authors.forename: Liping
authors.initials: L
authors.lastname: Yu
authors.affiliation: Center for Biotechnology and Genomic Medicine, Medical College of Georgia, GA Regents University, Augusta, 30912, USA.
authors.forename: Jinxiong
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authors.affiliation: Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China. zhangmei@njmu.edu.cn.
authors.forename: Mei
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China. yangt@njmu.edu.cn.|Key Laboratory of Human Functional Genomics of Jiangsu Province, Nanjing Medical University, Nanjing, 210000, China. yangt@njmu.edu.cn.
authors.forename: Tao
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authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D044466:Asian People; D001323:Autoantibodies / Q000097:blood / Q000276:immunology*; D015992:Body Mass Index; D002096:C-Peptide / Q000097:blood; D027682:Cation Transport Proteins / Q000276:immunology; D002681:China; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000208:ethnology / Q000276:immunology*; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005968:Glutamate Decarboxylase / Q000276:immunology; D006801:Humans; D007328:Insulin / Q000276:immunology; D007515:Islets of Langerhans / Q000276:immunology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011863:Radioimmunoassay; D054635:Receptor-Like Protein Tyrosine Phosphatases, Class 8 / Q000276:immunology; D012307:Risk Factors; D055815:Young Adult; D000075703:Zinc Transporter 8
chemical_list: D001323:Autoantibodies; D002096:C-Peptide; D027682:Cation Transport Proteins; D007328:Insulin; C492522:SLC30A8 protein, human; D000075703:Zinc Transporter 8; C024211:islet cell antibody; C516862:PTPRN protein, human; D054635:Receptor-Like Protein Tyrosine Phosphatases, Class 8; D005968:Glutamate Decarboxylase
keywords: autoantibodies; heterogeneity; islet failure; type 1 diabetes