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Analysis of pathogenesis of juvenile new-onset diabetes.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Wang, Jian Miao, Dongmei Wang, Yangtian Lu, Bin Babu, Sunanda Klingensmith, Georgeanna Rewers, Marian Eisenbarth, George S. Yu, Liping
Description	Country affiliation: China Author Affiliation: Wang J ( Department of Endocrinology, Nanjing Jinling Hospital, Nanjing, Jiangsu, China.)
Abstract	BACKGROUND: Measurement of anti-islet autoantibodies at the time of disease onset contributes greatly to the differentiation of Type 1A diabetes with HLA Class II subtyping also contributing. METHODS: Blood samples were obtained from 900 patients with age from 1 month to 25 years (median age 11.1 years) within 2 weeks of diabetes onset to test anti-islet autoantibodies to insulin (IAA), glutamic acid decarboxylase (GADA), insulinoma antigen (IA-2AA), the zinc transporter-8 (ZnT8AA), and islet-cell antibodies (ICA). Polymorphisms of the HLA Class II gene were typed in 547 randomly selected patients. RESULTS: Of the 900 subjects analyzed, 145 (16.1%) were negative for all five anti-islet autoantibodies, and autoantibody negativity significantly increased with age: 10.2% (38/372) among children <10 years of age, 14.2% (46/325) in those 10-14 years of age, and 30.1% (61/203) in those >14 years of age (P < 0.001). The prevalence of IA-2AA was the highest among young children. The prevalence of GADA increased with age while the prevalence of IAA was inversely correlated with age. At diagnosis, the subjects with negative antibodies had a higher body mass index (P < 0.001) and less high risk HLA genotype DR3-DQ2/DR4-DQ8 (P < 0.01). CONCLUSION: A large percentage of children and youths negative for all anti-islet autoantibodies at the onset of diabetes are likely to have the non-immune form, especially those without DR3/DR4 and obese patients. Among autoantibody-positive Type 1A patients, IAA and GADA showed a reciprocal prevalence, suggesting differential disease pathogenesis.
File Format	HTM / HTML
ISSN	17530393
e-ISSN	17530407
DOI	10.1111/j.1753-0407.2010.00105.x
Journal	Journal of Diabetes
Issue Number	2
Volume Number	3
Language	English
Publisher	Wiley-Blackwell
Publisher Date	2011-06-01
Publisher Place	Australia
Access Restriction	Open
Subject Keyword	Discipline Endocrinology Autoantibodies Immunology Diabetes Mellitus, Type 1 Histocompatibility Antigens Class Ii Islets Of Langerhans Adolescent Blood Genetics Cation Transport Proteins Child, Preschool Cohort Studies Chemistry Glutamate Decarboxylase Infant Insulin Insulinoma Logistic Models Polymerase Chain Reaction Polymorphism, Genetic Research Support, N.i.h., Extramural
Content Type	Text
Resource Type	Article
Subject	Endocrinology, Diabetes and Metabolism

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