Newly Diagnosed Latent Autoimmune Diabetes in Adults (LADA) is Associated with Low Level Glutamate Decarboxylase (GAD65) and IA-2 Autoantibodies

D. B. Schranz; L. Bekris; M. Landin-Olsson; C. Törn; A. Niläng; Å Toll; J. Sjöström; H. Grönlund; Å Lernmark; for the Diabetes Incidence Study in Sweden (DISS)

doi:10.1055/s-2007-978607

Hormone and Metabolic Research, Table of Contents

Horm Metab Res 2000; 32(4): 133-138
DOI: 10.1055/s-2007-978607

Originals Clinical

Newly Diagnosed Latent Autoimmune Diabetes in Adults (LADA) is Associated with Low Level Glutamate Decarboxylase (GAD65) and IA-2 Autoantibodies

D. B. Schranz¹ , L. Bekris¹ , M. Landin-Olsson² , C. Törn² , A. Niläng¹ , Å. Toll¹ , J. Sjöström¹ , H. Grönlund³ , Å. Lernmark¹ , for the Diabetes Incidence Study in Sweden (DISS)*

¹Department of Medicine, Robert H. Williams Laboratory, University of Washington, Seattle, USA
²Diabetes Laboratory, University Hospital, Lund, Sweden
³Pharmacia Diagnostics, Uppsala, Sweden

* The co-authors ofthe DISS group are: Hans J. Arnqvist, Department of Internal Medicine, University of Linköping, Linköping; Elisabeth Björk, Department of Medicine, University Hospital Uppsala, Uppsala; Göran Blohmé, Department of Medicine, Sahlgrenska University Hospital, Gothenburg; Jan Bolinder, Center for Metabolism and Endocrinology, Huddinge University Hospital, Stockholm; Jan Eriksson and Folke Lithner, Department of Medicine, Umeå University Hospital, Umeå; Bengt Littorin, Department of Community Health Sciences, Lund; Lennarth Nyström, Department of Epidemiology and Public Health, University of Umeå, UmeŽ; Bengt Scherstén, Department of Community Health Sciences, Lund University, Lund; Lars Wibell, Department of Medicine, University Hospital Uppsala, Uppsala; Göran Sundkvist, Department of Endocrinology, Malmö; University Hospital, Malmö; and Jan Östman, Center for Metabolism and Endocrinology, Huddinge University Hospital, Stockholm, Sweden.

Abstract

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A quantitative assay with microSepharose was used to determine GAD65Ab and IA-2Ab levels in 771 population-based patients diagnosed with diabetes mellitus at 15 to 34 years of age, and in 828 matched controls. Among the patients, 587 (76%) were classified with type I, 108 (14%) with type II, and 76 (10%) with unclassifiable diabetes. The levels above normal demonstrated a prevalence of GAD65Ab in 66% of type I diabetes, 50% of type II diabetes and 54% of unclassifiable patients and for IA-2Ab in 40%, 17% and 21%, respectively. Among the autoantibody-positive sera, the LADA patients had a lower GAD65Ab index (median 0.19, p < 0.0001) and IA-2Ab index (median 0.28, p < 0.0001) than the type I patients (median 0.37 and 0.66). Patients with unclassifiable diabetes had a GAD65Ab (median 0.43) or IA-2Ab (median 0.63) index which was not different from the type I diabetes patients. Our data demonstrate that young adult new-onset LADA patients have low level GAD65Ab and IA-2Ab. The low-level autoantibodies may signify a less aggressive beta-cell autoimmunity, which may explain why these patients are often classified with type II or non-insulin-dependent diabetes.

Key words

Autoimmunity - Diabetes Mellitus - Islet Cell Autoantibodies - Type I Diabetes - Type II Diabetes - ROC Curve

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