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Islet cell antibodies are associated withβ-cell failure also in obese adult onset diabetic patients

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Abstract

To clarify the utility of islet cell antibodies (ICA) to correctly classify and predict insulin treatment in newly diagnosed diabetic subjects, ICA, body mass index (BMI), glycated hemoglobin (HbA1c), and fasting plasma C-peptide values were evaluated at and 3 years after diagnosis in 233 new, consecutively diagnosed, adult diabetic patients classified as obese or nonobese (National Diabetes Data Group, NDDG criteria). Among the 233 patients, 31 were nonobese ICA-positive (mean age at diagnosis 43±3 years), 55 nonobese ICA-negative (mean age at diagnosis 58±2 years), 7 obese ICA-positive (mean age at diagnosis 57±5 years), and 139 obese ICA-negative (mean age at diagnosis 58±1 years). Fasting C-peptide decreased (P<0.05) in nonobese ICA-positive patients who after 3 years showed lower BMI (22.6±0.6 versus 24.5±0.4;P<0.05), lower fasting C-peptide (0.14±0.06 nmol/l versus 0.71±0.07 nmol/l;P<0.001), and higher frequency of insulin treatment [28/31 (90%) versus 6/45 (13%);P<0.001] than nonobese ICA-negative patients. In obese ICA-positive patients, fasting C-peptide also decreased (Δ C-peptide 0.17±0.04 nmol/l;P<0.05) after diagnosis, and 3 years after diagnosis, obese ICA-positive patients showed lower BMI (25.7±1.2 versus 29.8±0.4;P<0.01) and fasting C-peptide (0.08±0.04 nmol/l versus 1.06±0.05 nmol/l;P<0.001) and higher HbA1c values (9.92%±0.68% versus 7.39%±0.21%;P<0.01) and a higher frequency of insulin treatment [7/7 (100%) versus 5/121 (4%);P<0.001] than obese ICA-negative patients. Therefore, ICA detected at diagnosis of diabetes in both obese and nonobese adult patients indicate β-cell dysfunction, high HbA1c levels, and progression to insulin dependency.

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References

  1. West KM, Kalbfleisch JM, Influence of nutritional factors on prevalence of diabetes. Diabetes 20: 99–108, 1971

    Google Scholar 

  2. Melton J, Palumbo P, Chu-pin C, Incidence of diabetes mellitus by clinical type. Diabetes Care 6: 75–86, 1983

    Google Scholar 

  3. Laakso M, Pyörälä K, Age of onset and type of diabetes. Diabetes Care 8: 114–117, 1985

    Google Scholar 

  4. Eriksson J, Forsén B, Häggblom M, Teppo A-M, Groop L, Clinical and metabolic characteristics of type 1 and type 2 diabetes: an epidemilogical study from the Närpes community in western Finland. Diabetic Med 9: 654–660, 1992

    Google Scholar 

  5. Hother-Nielsen O, Faber O, Sørensen NS, Beck-Nielsen H, Classification of newly diagnosed diabetic patients as insulinrequiring or non-insulin-requiring based on clinical and biochemical variables. Diabetes Care 11: 531–537, 1988

    Google Scholar 

  6. MacIver D, McNally P, Shaw D, Hearnshaw J, Predicting future treatment of diabetes mellitus from characteristics available at presentation. Diabetic Med 5: 766–770, 1988

    Google Scholar 

  7. WHO Study Group, Report of diabetes mellitus technical report series no. 727. WHO, Geneva, 1985

  8. Groop LC, Eriksson J, Ekstrand A, Franssila-Kallunki A, Saloranta C, Miettinen A, Metabolic characteristics of autoimmune diabetes in adults. Diabetologia 34: 46–51, 1991

    Google Scholar 

  9. Kobayashi T, Tamemoto K, Nakanishi K, Kato N, Okubo M, Kajio H, Sugimoto T, Murase T, Kosaka K, Immunogenetic and clinical characterization of slowly progressive IDDM. Diabetes Care 16: 780–788, 1993

    Google Scholar 

  10. Irvine WJ, McCallum CJ, Gray RS, Cambell CJ, Duncan LJP, Farquhar JW, Vaughan H, Morris PJ, Pancreatic islet cell antibodies in diabetes mellitus correlated with the duration and type of diabetes, coexistent autoimmune disease and HLA-type. Diabetes 26: 138–147, 1977

    Google Scholar 

  11. Irvine WJ, Sawers JSA, Feek CM, Prescott RJ, Duncanc JP, The value of islet cell antibody in predicting secondary failure of oral hypoglycemic agent therapy in diabetes mellitus. J Clin Immunol 2:23–26, 1979

    Google Scholar 

  12. Di Mario U, Irvine WJ, Borsey DQ, Kyner JL, Weston J, Galfo C, Immune abnormalities in diabetic patients not requiring insulin at diagnosis. Diabetologia 25:392–395, 1983

    Google Scholar 

  13. Gleichmann H, Zörcher B, Greulich B, Gries FA, Henrichs HR, Bertrams J, Kolb H, Correlation of islet cell antibodies and HLA-DR phenotypes with diabetes mellitus in adults. Diabetologia 27:90–92, 1984

    Google Scholar 

  14. Groop LC, Bottazzo GF, Doniac D, Islet cell antibodies identify latent type 1 diabetes in patients aged 35–75 years at diagnosis. Diabetes 35:237–241, 1986

    Google Scholar 

  15. Landin-Olsson M, Nilsson K-O, Lernmark Å, Sundkvist G, Islet cell antibodies and fasting C-peptide predict insulin requirement at diagnosis of diabetes mellitus. Diabetologia 33:561–568, 1990

    Google Scholar 

  16. Landin-Olsson M, Karlsson F, Lernmark Å, Sundkvist G, The DISS group, Islet cell and thyrogastric antibodies in 633 consecutive 15- to 34-yr-old patsients in the diabetes incidence study in Sweden. Diabetes 41:1022–1027, 1992

    Google Scholar 

  17. Kobayashi T, Itoh T, Kasaka K, Sato K, Tsuji K, Time course of islet cell antibodies and β-cell function in non-insulin-dependent stage of Type 1 diabetes. Diabetes 36:510–517, 1987

    Google Scholar 

  18. Gottsäter A, Landin-Olsson M, Fernlund P, Lernmark Å, Sundkvist G, β-cell function in relation to islet cell antibodies (ICA) during the first three years after the clinical diagnosis of diabetes in non-insulin-dependent (type II) diabetic patients. Diabetes Care 16:902–910, 1993

    Google Scholar 

  19. National Diabetes Data Group (NDDG), Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes 28: 1039–1057, 1979

    Google Scholar 

  20. Jeppsson J-O, Jerntorp P, Sundkvist G, Englund H, Nylund V, Measurement of hemoglobin A1c by a new liquid-chromatographic assay: methodology, clinical utility, and relation to glucose tolerance evaluated. Clin Chem 32:1867–1872, 1986

    Google Scholar 

  21. Heding L, Radioimmunological determination of C-peptide in serum. Diabetologia 11:541–548, 1975

    Google Scholar 

  22. Gottsäter A, Landin-Olsson M, Fernlund P, Gullberg B, Lernmark Å, Sundkvist G, Pancreatic beta-cell function evaluated by intravenous glucose and glucagon stimulation. A comparison between insulin and C-peptide to measure insulin secretion. Scand J Clin Lab Invest 52:631–639, 1992

    Google Scholar 

  23. Madsen OD, Landin-Olsson M, Bille G, Sundkvist G, Lernmark Å, Dahlquist G, Ludvigsson J, A two-colour immunofluorescence test with a monoclonal human proinsulin antibody improves the assay for islet cell antibodies. Diabetologia 29:115–118, 1986

    Google Scholar 

  24. Landin-Olsson M, Sundkvist G, Lenmark Å, Prolonged incubation on the two-colour immunofluorescent test increases the prevalence and titres of islet cell antibodies in Type 1 (insulin-dependent) diabetes mellitus. Diabetologia 30:327–332, 1987

    Google Scholar 

  25. Boitard C, Bonifacio E, Bottazzo GF, Gleishmann H, Molenaar J, Immunology and diabetes workshop: report on the third international (stage 3) workshop on the standardisation of cytoplasmic islet cell antibodies. Diabetologia 31:451–452, 1988

    Google Scholar 

  26. Landin-Olsson M, Karlsson A, Dahlquist G, Blom L, Lernmark Å, Sundkvist G, Islet cell and other organ-specific autoantibodies in all children developing Type 1 (insulin-independent) diabetes mellitus in Sweden during one year and in matched controls. Diabetologia 32:387–395, 1989

    Google Scholar 

  27. Lyons TJ, Kennedy L, Atkinson AB, Buchanan KD, Hadden DR, Weaver JA, Predicting the need for insulin therapy in late onset (40–69 years) diabetes mellitus. Diabetic Med 1:105–107, 1984

    Google Scholar 

  28. Pontiroli AE, Calderara A, Capra F, Fattor B, Illeni MT, Pozza G, HLA phenotype and secondary failure to oral hypoglycaemic agents. Diabetologia 30:824–825, 1987

    Google Scholar 

  29. Pontiroli AE, Calderara A, Maffi P, Bonisolli A, Carenini PM, Piatti PM, Monti LD, Gallus G, Pozza G, Illeni MT, Secondary failure to oral hypoglycaemic agents in non-obese patients with non-insulin-dependent diabetes is related to reduced insulin release. Diabete Metab 15:79–84, 1989

    Google Scholar 

  30. Laakso M, Rönnemaa T, Sarlund H, Pyörälä K, Kallio V, Factors associated with fasting and postglucagon plasma C-peptide levels in middle-aged insulin-treated diabetic patients. Diabetes Care 12:83–88, 1989

    Google Scholar 

  31. Niskanen LK, Uusitupa MI, Sarlund H, Siitonen O, Pyörälä K, Five-year follow-up study on plasma insulin levels in newly diagnosed NIDDM patients and nondiabetic subjects. Diabetes Care 13:41–47, 1990

    Google Scholar 

  32. Niskanen L, Karjalainen J, Sarlund H, Siitonen O, Uusitupa M, Five-year follow-up of islet cell antibodies in type 2 (non-insulin-dependent) diabetes mellitus. Diabetologia 34: 402–408, 1991

    Google Scholar 

  33. Arnold-Larsen S, Madsbad S, Kühl C Reproducibility of the glucagon test. Diabetic Med 4:299–303, 1987

    Google Scholar 

  34. Gjessing HJ, Reinholdt B, Pedersen O, The plasma C-peptide and insulin responses to stimulation with intravenous glucose and a mixed meal in well controlled type 2 (non-insulin-dependent) diabetes mellitus: dependency on acutely established hyperglycaemia. Diabetologia 32:858–863, 1989

    Google Scholar 

  35. Davalli AM, Ricordi C, Socci C, Braghi S, Bertuzzi F, Fattor B, Di Carlo V, Pontiroli AE, Pozza G, Abnormal sensitivity to glucose of human islets cultured in a high glucose medium: partial reversibility after an additional culture in a normal glucose medium. J Clin Endocrinol Metab 72:202–208, 1991

    Google Scholar 

  36. Davalli AM, Pontiroli AE, Socci C, Bertuzzi F, Fattor B, Braghi S, Di Carlo V, Pozza G, Human islets chronically exposed in vitro to different stimuli become unresponsive to the same stimuli given acutely: evidence supporting specific desensitization rather than β-cell exhaustion. J Clin Endocrinol Metab 74:790–794, 1992

    Google Scholar 

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Authors and Affiliations

  1. Department of Medicine, University of Lund, onMalmö General Hospital, S-214 01, Malmö, Sweden

    A. Gottsäter, M. Landin-Olsson, Å. Lernmark & G. Sundkvist

  2. Karolinska Institute, Department of Endocrinology, Karolinska Hospital, Stockholm, Sweden

    Å. Lernmark

  3. Department of Clinical Chemistry, University of Lund, Malmö General Hospital, Malmö, Sweden

    P. Fernlund

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  1. A. Gottsäter
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  2. M. Landin-Olsson
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  3. Å. Lernmark
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  4. P. Fernlund
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  5. G. Sundkvist
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Gottsäter, A., Landin-Olsson, M., Lernmark, Å. et al. Islet cell antibodies are associated withβ-cell failure also in obese adult onset diabetic patients. Acta Diabetol 31, 226–231 (1994). https://doi.org/10.1007/BF00571956

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  • DOI: https://doi.org/10.1007/BF00571956

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