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The prevalence of the 65-kilodalton isoform of glutamic acid decarboxylase autoantibodies by glucose tolerance status in elderly patients from the cardiovascular health study.
- Source :
-
The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2006 Aug; Vol. 91 (8), pp. 2871-7. Date of Electronic Publication: 2006 May 23. - Publication Year :
- 2006
-
Abstract
- Context: Autoantibodies (AA) to glutamic acid decarboxylase (GAD65), a determinant of risk for autoimmune diabetes, have been found in up to 10% of patients with type 2 diabetes. In older adults, this marker may also serve as a determinant of risk for autoimmune diabetes and enhance diabetes classification.<br />Objective: The objective of this study was to evaluate the relationship between GAD65AA and glucose tolerance status, current diabetes treatment, and clinical measures in older adults.<br />Design: GAD65AA were measured at baseline in 3318 participants from the Cardiovascular Health Study, a cohort study of 5888 individuals 65 or older.<br />Setting: The population-based cohort was recruited from four U.S. sites.<br />Patients: Patients included all Cardiovascular Health Study participants with known diabetes, newly diagnosed diabetes, impaired fasting glucose, impaired glucose tolerance, and a sample of normal glucose-tolerant participants.<br />Main Outcome Measures: GAD65AA, body mass index, fasting glucose and insulin levels, blood pressure, lipid levels, and diabetes treatment at baseline were measured.<br />Results: The prevalence of GAD65AA increased with decreasing glucose tolerance in both Blacks (n = 560) and Whites (n = 2730), being more pronounced in known diabetic individuals. GAD65AA were found in 2.3, 5.8, 7.8, and 8.3% of diabetic participants, reporting use of no diabetes medication, oral hypoglycemic agents, insulin only, and both oral hypoglycemic agents and insulin, respectively (P = 0.02, linear trend). Among diabetic participants, GAD65AA positivity was associated with diabetes treatment, higher fasting glucose, and lower body mass index.<br />Conclusions: Even among older individuals with diabetes, GAD65AA may be a useful marker in identifying a subgroup of autoimmune diabetes, serve as a marker of insulin requirement, and remain stable over years.
- Subjects :
- Aged
Blood Glucose analysis
Blood Pressure
Cardiovascular Diseases
Cohort Studies
Diabetes Mellitus, Type 2 enzymology
Diabetes Mellitus, Type 2 immunology
Fasting
Female
Humans
Insulin blood
Lipids blood
Logistic Models
Male
Nutrition Surveys
Aging
Autoantibodies blood
Glucose Intolerance immunology
Glutamate Decarboxylase immunology
Isoenzymes immunology
Subjects
Details
- Language :
- English
- ISSN :
- 0021-972X
- Volume :
- 91
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- The Journal of clinical endocrinology and metabolism
- Publication Type :
- Academic Journal
- Accession number :
- 16720660
- Full Text :
- https://doi.org/10.1210/jc.2005-2667