The optimal cutoff point of glutamate decarboxylase antibody (GAD-Ab) titers for differentiating two latent autoimmune diabetes (LADA) subtypes remains unclear. One hundred and forty-five GAD-Ab-positive patients screened from phenotypic type 2 diabetes were diagnosed as LADA. The clinical features were compared among LADA patients with different GAD-Ab titers. The receiver-operating characteristic (ROC) curve was used to evaluate the diagnostic value of GAD-Ab titers and to define the optimal cutoff point. The heterogeneity of clinical features in LADA could be discriminated by five GAD-Ab titers, with maximal differences at the titer of 175 U/mL. The ROC curve analysis showed that the optimal cutoff point for discriminating two LADA subtypes was at the titer of 175 U/mL, with sensitivity and specificity of 54.5% and 92.1%, respectively. These findings demonstrated that the two clinically distinct subtypes of LADA can be optimally discriminated by the GAD-Ab titers.

1. The present study compared the activity of catechol- O-methyltransferase (COMT) in the liver and plasma of streptozotocin (STZ)-induced diabetic rats with that in normal rats. The activity of COMT was estimated by the metabolism of noradrenaline to metanephrine (MN), both measured by high-performance liquid chromatography with electrochemical detection. 2. Formation of MN was decreased in the liver of STZ- diabetic rats compared with normal rats. The amount of MN was also decreased in plasma obtained from STZ-diabetic rats. A Michaelis-Menten plot showed a reduction in the maximum velocity and an increase in the Km for COMT in liver samples from STZ-diabetic rats. 3. The role of hyperglycaemia in the lowering of COMT activity was then investigated using phlorizin or insulin at doses sufficient to normalize plasma glucose from STZ-diabetic rats. Both insulin and phlorizin treatment of STZ-diabetic rats for 4 days restored the activity of COMT to that seen in normal rats. Thus, correction of hyperglycaemia in STZ-diabetic rats can reverse the decrease in COMT activity. The activity of COMT is lower in STZ-diabetic rats than in normal rats mainly due to the higher plasma glucose.