Diabetes mellitus among young adults in Sri Lanka--role of GAD antibodies in classification and treatment: the Sri Lanka Young Diabetes study.

IF 10.2 1区医学 Q1 ENDOCRINOLOGY & METABOLISM Diabetologia Pub Date : 2008-08-01 Epub Date: 2008-06-05 DOI:10.1007/s00125-008-1052-6

P Katulanda, B Shine, G W Katulanda, A Silva, E L Asfir, R Sheriff, N Somasundaram, A E Long, P J Bingley, M I McCarthy, A Clark, D R Matthews

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引用次数: 27

Abstract

Aims/hypothesis: Diabetes mellitus is increasing among young adult South Asians. The aim of this study was to determine the prevalence and phenotypic characteristics of diabetes subtypes based on GAD65 autoantibody (GADA) status in those with young adult-onset diabetes in Sri Lanka.

Methods: Clinical, metabolic and GADA data were available for 992 consecutively recruited individuals with diabetes aged < or =45 years (age at diagnosis 16-40 years). Participants were classified according to the following definitions: type 1 diabetes, insulin-dependent <6 months from diagnosis; latent autoimmune diabetes in adults (LADA), GADA-positive, age > or =30 years and insulin-independent > or =6 months from diagnosis; type 2 diabetes, GADA-negative and insulin-independent > or =6 months from diagnosis.

Results: The median (interquartile range) age at diagnosis and diabetes duration were 33.0 (29.0-36.1) and 4.0 (1.1-7.1) years, respectively; 42.1% were male. GADA positivity was seen in 5.4% of participants (n = 54) and GADA levels negatively correlated with age at diagnosis (p < 0.0001), BMI (p < 0.0001) and time to insulin requirement (p = 0.006). Type 1 diabetes, type 2 diabetes and LADA were present in 7.0%, 89.7% and 2.6%, respectively. The remaining 0.7% of the participants were GADA-positive, insulin independent > or =6 months from diagnosis and were diagnosed at age <30 years. The metabolic syndrome and homeostasis model assessment of beta cell function (HOMA %B) were lowest in GADA-positive type 1 diabetes and increased progressively in latent autoimmune diabetes, GADA-negative type 1 diabetes and type 2 diabetes. Among those requiring insulin, 69.2% had fasting C-peptide levels in the lowest quartile, whereas only 19.5% were GADA-positive (p < 0.0001).

Conclusions/interpretation: The prevalence of GADA-positive autoimmune diabetes is low among individuals with young adult-onset diabetes in Sri Lanka. Young-onset diabetic phenotypes appear as a continuum from autoimmune type 1 diabetes to type 2 diabetes.

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斯里兰卡青年糖尿病——GAD抗体在糖尿病分类和治疗中的作用:斯里兰卡青年糖尿病研究

目的/假设:糖尿病在南亚年轻人中呈上升趋势。本研究的目的是基于GAD65自身抗体(GADA)状态确定斯里兰卡年轻成人发病糖尿病患者中糖尿病亚型的患病率和表型特征。方法:收集992例年龄≤45岁(诊断时年龄16-40岁)的糖尿病患者的临床、代谢和GADA数据。参与者根据以下定义进行分类:1型糖尿病，胰岛素依赖型或=30年，胰岛素依赖型>或=6个月;2型糖尿病，gada阴性且胰岛素不依赖型>或=诊断后6个月结果:诊断年龄和糖尿病病程的中位数(四分位数间距)分别为33.0(29.0-36.1)岁和4.0(1.1-7.1)岁;42.1%为男性。5.4%的参与者(n = 54)出现GADA阳性，GADA水平与诊断年龄(p < 0.0001)、BMI (p < 0.0001)和胰岛素需求时间(p = 0.006)呈负相关。1型糖尿病、2型糖尿病和LADA患病率分别为7.0%、89.7%和2.6%。其余0.7%的参与者为gada阳性，在诊断>或=6个月后胰岛素独立，并且在年龄时被诊断出来。结论/解释:在斯里兰卡，gada阳性自身免疫性糖尿病在年轻成人发病糖尿病患者中的患病率较低。年轻发病的糖尿病表型表现为从自身免疫性1型糖尿病到2型糖尿病的连续体。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetologia 医学-内分泌学与代谢

CiteScore

18.10

自引率

2.40%

发文量

193

审稿时长

1 months

期刊介绍： Diabetologia, the authoritative journal dedicated to diabetes research, holds high visibility through society membership, libraries, and social media. As the official journal of the European Association for the Study of Diabetes, it is ranked in the top quartile of the 2019 JCR Impact Factors in the Endocrinology & Metabolism category. The journal boasts dedicated and expert editorial teams committed to supporting authors throughout the peer review process.