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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.
Tuesday,2012-11-06 12:07 America/Los_Angeles — eenright
| Title | The prevalence of the 65-kilodalton isoform of glutamic acid decarboxylase autoantibodies by glucose tolerance status in elderly patients from the cardiovascular health study. |
| Publication Type | Journal Article |
| Year of Publication | 2006 |
| Authors | Barinas-Mitchell, E, Kuller, LH, Pietropaolo, S, Zhang, Y-J, Henderson, T, Pietropaolo, M |
| Journal | J Clin Endocrinol Metab |
| Volume | 91 |
| Issue | 8 |
| Pagination | 2871-7 |
| Date Published | 2006 Aug |
| ISSN | 0021-972X |
| Keywords | Aged, Aging, Autoantibodies, Blood Glucose, Blood Pressure, Cardiovascular Diseases, Cohort Studies, Diabetes Mellitus, Type 2, Fasting, Female, Glucose Intolerance, Glutamate Decarboxylase, Humans, Insulin, Isoenzymes, Lipids, Logistic Models, Male, Nutrition Surveys |
| Abstract | <p><b>CONTEXT: </b>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.</p><p><b>OBJECTIVE: </b>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.</p><p><b>DESIGN: </b>GAD65AA were measured at baseline in 3318 participants from the Cardiovascular Health Study, a cohort study of 5888 individuals 65 or older.</p><p><b>SETTING: </b>The population-based cohort was recruited from four U.S. sites.</p><p><b>PATIENTS: </b>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.</p><p><b>MAIN OUTCOME MEASURES: </b>GAD65AA, body mass index, fasting glucose and insulin levels, blood pressure, lipid levels, and diabetes treatment at baseline were measured.</p><p><b>RESULTS: </b>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.</p><p><b>CONCLUSIONS: </b>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.</p> |
| DOI | 10.1210/jc.2005-2667 |
| Alternate Journal | J Clin Endocrinol Metab |
| PubMed ID | 16720660 |
| Grant List | N01 HC 15103 / HC / NHLBI NIH HHS / United States N01 HC 35129 / HC / NHLBI NIH HHS / United States N01 HC 85079 / HC / NHLBI NIH HHS / United States N01 HC 85080 / HC / NHLBI NIH HHS / United States N01 HC 85081 / HC / NHLBI NIH HHS / United States N01 HC 85082 / HC / NHLBI NIH HHS / United States N01 HC 85083 / HC / NHLBI NIH HHS / United States N01 HC 85084 / HC / NHLBI NIH HHS / United States N01 HC 85085 / HC / NHLBI NIH HHS / United States N01 HC 85086 / HC / NHLBI NIH HHS / United States P30 DK 046204 / DK / NIDDK NIH HHS / United States R01 DK 056200 / DK / NIDDK NIH HHS / United States |