Influence of age at diagnosis and duration of diabetes on the positivity of glutamic acid decarboxylase antibody in South-Brazilian type 1 diabetes mellitus

Maraschin, Jorge de Faria; Weinert, Letícia Schwerz; Murussi, Nádia; Witter, Vanessa; Rodrigues, Ticiana da Costa; Rossato, Egna Regina; Silveiro, Sandra Pinho

doi:10.1177/0004563212474560

Cited by 3 publications

(5 citation statements)

References 35 publications

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“…In a cross‐sectional study, Maraschin et al evaluated GAD in 92 Brazilian individuals with type 1 diabetes and found that about half had positive GAD. Even though the positivity rate declined over time, it can stay positive up to 15 years after diagnosis, and the best diagnostic performance of GAD was in patients with diabetes duration <15 years, and with diabetes onset after 16 years of age 19 . In comparison, our study followed patients for a mean diabetes duration of 7.3 years and found that 83% of participants with baseline positive DA remained positive.…”

Section: Discussionmentioning

confidence: 67%

A longitudinal assessment of diabetes autoantibodies in the SEARCH for diabetes in youth study

et al. 2022

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To assess changes in diabetes autoantibodies (DAs) over time in children and young adults with diabetes and determine whether observed changes were associated with demographic characteristics, clinical parameters and diabetes complications. Participants had DAs measured at baseline (10.3 ± 7.1 months after diabetes diagnosis) and at 12, 24 months and ≥5 years after the baseline measurement. At the ≥5-year follow-up, the presence of diabetes complications was assessed. We examined the associations between change in number of positive DAs and changes in individual DA status with the participants' characteristics and clinical parameters over time. Out of 4179 participants, 62% had longitudinal DA data and 51% had complications and longitudinal DA data. In participants with ≥1 baseline positive DA (n = 1699), 83.4% remained positive after 7.3 ± 2.3 years duration of diabetes. Decrease in number of positive DAs was associated with longer diabetes duration (p = 0.003 for 1 baseline positive DA; p < 0.001 for 2 baseline positive DAs) and younger age at diagnosis (p < 0.001 for 2 baseline positive DAs). No associations were found between change in number of positive DAs in participants with ≥1 baseline positive DA (n = 1391) and HbA1c, insulin dose, acute, or chronic complications after 7.7 ± 1.9 years duration of diabetes. DA status likely remains stable in the first 7 years after diabetes diagnosis. Younger age at diabetes diagnosis and longer duration were associated with less persistence of DAs. Measuring DAs after initial presentation may aid in diabetes classification but not likely in predicting the clinical course.

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Section: Discussionmentioning

confidence: 67%

A longitudinal assessment of diabetes autoantibodies in the SEARCH for diabetes in youth study

et al. 2022

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“…There are several st udies on serum GADA levels an d T1D i.e., 36‐38 . Increased levels of GADA at the onset of T1D have been associated with diabetic retinopathy that is the most common microvascular complication of diabetes 15 .…”

Section: Discussionmentioning

confidence: 99%

Periodontal conditions, retinopathy, and serum markers in individuals with type 1 diabetes

Widén

Holmer

Sättlin

et al. 2020

Journal of Periodontology

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Background: The prevalence of diabetes is high and increasing. Periodontitis has been identified as a risk factor in both type 1 and 2 diabetes. The study purpose was to assess periodontal conditions, retinopathy, and serum glutamic acid decarboxylase antibody (GADA) titers in relation to retinopathy in individuals with type 1 diabetes (T1D). Methods: The study is a case series. Adult individuals with a diagnosis of T1D (n = 85) monitored ≥5 years were recruited from an endocrinology clinic. Peripheral venous blood samples were analyzed including assessments of serum HbA1c levels and GADA titers. Medical and periodontal conditions were examined, and the data assessed. Independent t tests, binary and multivariate analyses, χ 2 and odds ratios were employed. Results: Gingivitis was found in 68.2%, periodontitis in 21.2%, and retinopathy in 64.7%, GADA (≥35 U/mL) in 54.1%, and serum HbA1c > 48 mmol/mol in 94.3% of the individuals. The unadjusted odds ratio for periodontitis to differentiate a diagnosis of retinopathy was 7.3 (95%CI 1.6, 4.4, P <0.01). Multivariate analyses identified the following dependent factors to differentiate retinopathy; age, T1D duration, gingivitis, periodontitis at P < 0.001, sex, and serum GADA at P < 0.01, and by the number of remaining teeth at P < 0.05. Conclusion: Retinopathy as a complication to T1D is linked to the duration of diabetes, age of the individual and with increasing severity to periodontitis. Periodontal intervention studies are warranted.

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“…(1-3) T1D occurs due to the destruction of pancreatic beta cells due to autoimmune processes and only 2-5% are idiopathic. (1,4) Pancreatic beta cell destruction can be detected by autoantibody examination of pancreatic cells including glutamic acid decarboxylase 65 autoantibodies (GAD-65), islet cell autoantibodies (ICA), tyrosine phosphatase-like insulinoma antigen 2 (IA2), insulin autoantibodies (IAA), and β-cell-specific zinc transporter 8 autoantibodies (ZnT8). (5)(6)(7)(8) The percentage of antibodies against T1D depends on age, duration of disease, and ethnicity.…”

Section: Introductionmentioning

confidence: 99%

“…(5)(6)(7)(8) The percentage of antibodies against T1D depends on age, duration of disease, and ethnicity. (4,9) Furthermore, autoantibody levels provide information on the degree of beta cell damage, the onset of T1D symptoms, the need for insulin, prognosis, and the risk of other autoimmune diseases. Therefore, antibody examination is important to determine the etiology of pancreatic ß cell damage.…”

Section: Introductionmentioning

confidence: 99%

“…(14) It even still provides useful information up to 15 years after the diabetes diagnosis. (4) Regarding to the destruction of pancreatic beta cell in T1D pathogenesis, in addition to the presence of diabetesrelated autoantibodies, the absence of endogenous insulin secretion is often used to classify patient as having T1D. (15,16) The measurement of c-peptide is a well accepted method for the quantification of endogenous insulin because the degradation of insulin in the body is faster (halflife: 3-5 min) than that of c-peptide (halflife: of 20-30 min).…”

Section: Introductionmentioning

confidence: 99%

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Antibodies to Glutamic Acid Decarboxylase-65 is Associated with Total Daily Dose of Insulin Requirement in Children with Type 1 Diabetes

Faisal,

Rochmah,

Faizi

et al. 2023

Indones Biomed J

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BACKGROUND: Type 1 diabetes (T1D) mostly occurs due to the destruction of pancreatic beta cells due to autoimmune processes. Diagnosis of T1D can be established by examining the c-peptide levels and the markers of pancreatic autoantibodies, including glutamic acid decarboxylase 65 autoantibodies (GAD-65). However, the association between c-peptide and anti-GAD-65 toward patients’ clinical manifestations needs to be further explored. Hence, the aim of current study was to identify the association of anti-GAD65 with c-peptide and clinical characteristics in children with T1D.METHODS: Case-control study involving 47 T1D children (T1D group) and 41 healthy children (control group) younger than 18 years old was conducted. Secondary data regarding subjects’ demographic characteristics and medical history were collected from subjects, and serum blood was drawn from each subject for the anti-GAD65 and c-peptide measurement. Anti-GAD65 and c-peptide levels were measured using an Enzyme-Linked Immunosorbent Assay (ELISA) methods.RESULTS: Anti-GAD65 antibody was detected in 78.7% T1D group, while only 2.43% were detected in control group subject (p=0.0000). The c-peptide level of T1D group was 0.07±0.19 nmol/L and control group was 1.5±0.77 nmol/L (p=0.0000). The total daily dose of insulin in subjects with positive anti-GAD65 was greater than in the negative anti-GAD65 (p=0.012). The sensitivity and specificity of the anti-GAD65 were 85.4% was 66.7%, respectively.CONCLUSION: The results of this study show that anti-GAD65 was associated with total daily dose of insulin requirement in children with T1D.KEYWORDS: diabetes mellitus, type 1 diabetes, anti-GAD65, c-peptide

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Influence of age at diagnosis and duration of diabetes on the positivity of glutamic acid decarboxylase antibody in South-Brazilian type 1 diabetes mellitus

Abstract: GADA testing is a helpful tool in the diagnosis of type 1 DM starting in young adults and older individuals. Even though the positivity rate declines along the course of disease, it still provides useful information up to 15 y after the diabetes diagnosis.

Cited by 3 publications

References 35 publications

A longitudinal assessment of diabetes autoantibodies in the SEARCH for diabetes in youth study

A longitudinal assessment of diabetes autoantibodies in the SEARCH for diabetes in youth study

Periodontal conditions, retinopathy, and serum markers in individuals with type 1 diabetes

Antibodies to Glutamic Acid Decarboxylase-65 is Associated with Total Daily Dose of Insulin Requirement in Children with Type 1 Diabetes

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