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  • 1
    ISSN: 1432-0428
    Keywords: Key words Islet cell antibodies ; glutamic acid decarboxylase 65 antibodies ; islet autoantigens ; insulin-dependent diabetes mellitus prediction ; carboxypeptidase-H ; ICA69.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Identification of islet autoantigens offers the possibility that antibody tests other than islet cell antibodies may be used for assessing risk of insulin-dependent diabetes mellitus (IDDM). The aim of this study was to determine the combination of islet autoantibody markers that could identify most future cases of IDDM. Islet cell antibodies, antibodies to glutamic acid decarboxylase (GAD)65, 37,000/40,000 Mr islet tryptic fragments, carboxypeptidase-H, and islet cell autoantigen (ICA)69 were measured in sera from 100 newly-diagnosed IDDM patients, 27 individuals prior to onset of IDDM, and 83 control subjects. Islet cell antibodies were detected in 88 % of IDDM patients and 81 % with pre-IDDM, GAD65 antibodies in 70 % of IDDM patients and 89 % with pre-IDDM, and antibodies to 37,000/40,000 Mr islet tryptic fragments in 54 % of IDDM patients and in 48 % with pre-IDDM. The latter were found only in conjunction with islet cell antibodies and were more frequent in young onset cases. All 20 IDDM patients and the 3 pre-IDDM subjects who had islet cell antibodies without GAD65 antibodies had antibodies to 37,000/40,000 Mr islet tryptic fragments, and all but one had disease onset before age 15 years. No sera strongly immunoprecipitated in vitro translated ICA69 or carboxypeptidase-H; 4 % of patients had anti-ICA69 and 11 % anti-carboxypeptidase-H levels above those of the control subjects. The findings suggest that none of the single antibody specificities are as sensitive as islet cell antibodies, but that a combination of GAD65 antibodies and antibodies to 37,000/40,000 Mr islet tryptic fragments has the potential to identify more than 90 % of future cases of IDDM. Such a strategy could eventually replace islet cell antibodies in population screening for IDDM risk assessment. [Diabetologia (1995) 38: 816–822]
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-5233
    Keywords: Insulin-dependent diabetes mellitus ; HLA ; Genetic markers ; Risk assessment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Genetic markers may be used to improve the prediction of insulin-dependent diabetes mellitus (type 1) in individuals with islet autoantibodies. In order to develop a risk assessment strategy for the Lombardy region of northern Italy based on genetic and immunological markers, we analyzed HLA DQA1 and DQB1 alleles in 60 type 1 probands and their first-degree relatives and 65 unrelated control subjects from the same area using polymerase chain reaction (PCR) and oligonucleotide probes. The major risk haplotypes were DQA1 *0501-DQB1 *0201 (39.1% of diabetic vs 8.9% of non-diabetic haplotypes) and DQA1 *0301-DQB1 *0302 (20% of diabetic vs 7.1% of non-diabetic haplotypes). Stratified analysis showed DQA1 *0102-DQB1 *0502 also to be associated with type 1 susceptibility when found together with DQA1 *0501-DQB1 *0201 or DQA1 *0301-DQB1 *0302. One type 1 patient had the type 1-protective DQA1 *0102-DQB1 *0602 haplotype. Overall, 88% of patients and 20% of unrelated control subjects had either DQA1 *0501-DQB1 *0201 or DQA1 *0301-DQB1 *0302 in the absence of DQA1 *0102-DQB1 *0602. These data suggest that typing for markers identifying these three haplotypes in the Lombardy population will achieve a sensitivity of almost 90% and exclude 80% of children from subsequent islet autoantibody testing.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-5233
    Keywords: Key words C-peptide ; Type 1 diabetes mellitus ; Pubertal stage ; Remission
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To investigate the role of puberty on spontaneous clinical remission and on secretion of residual C-peptide during the first year of type 1 diabetes mellitus, we studied 77 pre-pubertal, 39 pubertal and 41 post-pubertal type 1 diabetic patients. Spontaneous partial clinical remission (HbA1c within the normal range and insulin dose less than 0.3 U ⋅ kg–1 body weight ⋅ day–1 lasting for at least 10 days) decreased with duration of diabetes: months 3 vs 6 vs 12, respectively 13 vs 7 vs 4% (P〈0.025). Remission was higher in post-pubertal than pubertal and pre-pubertal patients: month 6 respectively 20 vs 5 vs 1% (P〈0.001). Secretion of C-peptide was significantly lower in pre-pubertal than the other two groups of patients. Basal and stimulated C-peptide secretion were higher in patients in clinical remission than in those who were not: basal value 0.4 (0.26–0.53) vs 0.28 (0.14–0.4) nmol/l (P〈0.05); stimulated value 0.63 (0.5–0.95) vs 0.56 (0.31–0.74) nmol/l (P〈0.05). Spontaneous remission is less frequent in children and adolescent patients than in adult post-pubertal patients, but different mechanisms may be involved. Low residual insulin secretion seems implicated in children meanwhile low insulin sensitivity could be more important in pubertal patients.
    Type of Medium: Electronic Resource
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