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Soluble CD8 antigen, stimulated C-peptide and islet cell antibodies are predictors of insulin requirement in newly diagnosed patients with unclassifiable diabetes
Soluble CD8 antigen, stimulated C-peptide and islet cell antibodies are predictors of insulin requirement in newly diagnosed patients with unclassifiable diabetes
- Source :
- Acta Diabetologica. 33:220-224
- Publication Year :
- 1996
- Publisher :
- Springer Science and Business Media LLC, 1996.
-
Abstract
- To evaluate the predictive factors of insulin requirement in newly diagnosed patients with unclassifiable diabetes, 54 consecutive patients, aged less than 35 years, were prospectively followed for 3 years or more. At entry, haemoglobin HbA1c, basal and stimulated C-peptide concentrations, HLA phenotype, islet cell antibodies (ICA) status, and serum levels of soluble CD8 antigen (sCD8) were evaluated. After a median time of 9 (range 2-32) months, 31 patients (group 1) required insulin therapy, whereas 23 patients (group 2) remained non-insulin-requiring after 36 months. Group 1 patients were younger (P0.05) and had higher HbA1c and sCD8 serum levels (P0.0001), respectively), a higher frequency of ICA positivity and of HLA DR3 and/or DR4 phenotype (P0.005 and P0.0001, respectively), and lower C-peptide concentrations (P0.005 and P0.0001, basal and stimulated, respectively) than group 2. The sensitivity, specificity, positive and negative predictive value, and overall accuracy for the subsequent insulin requirement were: sCD8 serum levels (737 U/ml), 100%, 65%, 79%, 100% and 85%, respectively; stimulated C-peptide (0.60 nmol/l), 71%, 96%, 96%, 74% and 81%, respectively; and ICA positivity (20 JDFU), 45%, 91%, 87%, 55% and 65%, respectively. Thus, higher sCD8 serum levels, low stimulated C-peptide concentrations and ICA positivity are the most powerful predictors of subsequent recourse to insulin therapy in young, newly detected patients with unclassifiable diabetes.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
CD8 Antigens
Endocrinology, Diabetes and Metabolism
medicine.medical_treatment
Body Mass Index
Islets of Langerhans
Basal (phylogenetics)
chemistry.chemical_compound
HLA-DR3 Antigen
Endocrinology
Antigen
Antigens, CD
Predictive Value of Tests
Internal medicine
Diabetes mellitus
Diabetes Mellitus
Internal Medicine
Humans
Insulin
Medicine
Prospective Studies
Child
Autoantibodies
Glycated Hemoglobin
geography
geography.geographical_feature_category
C-Peptide
biology
business.industry
C-peptide
Histocompatibility Testing
Autoantibody
General Medicine
Glucose Tolerance Test
Glucagon
Islet
medicine.disease
Diabetes Mellitus, Type 1
chemistry
biology.protein
Female
Antibody
business
Biomarkers
Subjects
Details
- ISSN :
- 14325233 and 09405429
- Volume :
- 33
- Database :
- OpenAIRE
- Journal :
- Acta Diabetologica
- Accession number :
- edsair.doi.dedup.....59bc5edc9df2727057fe56bc3867cf3d
- Full Text :
- https://doi.org/10.1007/bf02048547