Relationship between HLA haplotype and BMI change in Japanese slowly progressive type 1 diabetes patients

Hoshina, Sari; Miura, Junnosuke; Uchigata, Yasuko

doi:10.1016/j.diabres.2016.12.006

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…A low BMI is related to decreased pancreatic digestive function, as evidenced by a small atrophic exocrine pancreas80 and low serum levels of pancreatic enzymes in patients with SPIDDM 81. In addition, Japanese individuals with SPIDDM and the T1D-risk HLA (DRB1*04:05-DQB1*04:01) haplotype had a lower BMI 82. Caucasian patients with LADA with a T1D-risk HLA (HLA DR3/4) had a lower BMI than those without the risk HLA phenotype 83.…”

Section: Risk Factors For Progression Of Beta-cell Dysfunction In Spiddmmentioning

confidence: 99%

<p>Slowly Progressive Type 1 Diabetes Mellitus: Current Knowledge And Future Perspectives</p>

Nishimura¹,

Matsumura²,

Kikuno³

et al. 2019

DMSO

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Slowly progressive type 1 insulin-dependent diabetes mellitus (SPIDDM), sometimes referred to as latent autoimmune diabetes in adults (LADA), is a heterogeneous disease that is often confused with type 1 and type 2 diabetes. As a result, there were few diagnostic criteria for this disorder until 2012, when the Japan Diabetes Society established criteria that could be used in clinical practice. A primary question is whether pathologic markers for type 1 or type 2 diabetes are present in the pancreas of patients with SPIDDM, because the phenotype of SPIDDM is similar to both type 1 and type 2 diabetes. Recent studies clarified pathologic findings in the pancreas of patients with SPIDDM, which included T-cell-mediated insulitis, a marker of type 1 diabetes; pseudoatrophic islets (islets specifically devoid of beta cells), another hallmark of type 1 diabetes; and a lack of amylin (ie, islet amyloid polypeptide) deposition to the islet cells, a pathologic marker of type 2 diabetes. In terms of preventing the loss of beta-cell function in patients with SPIDDM, several studies have shown that some drugs, including dipeptidyl peptidase-4 inhibitors, are effective. There is an increased need for early diagnosis of SPIDDM to preserve beta-cell function. This review presents updated findings on the pathogenesis and immunologic findings of the affected pancreas, diagnostic markers, risk factors for progression of beta-cell dysfunction, epidemiology, clinical features, diagnostic strategies, prevention strategies, and clinical options for patients with SPIDDM.

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Section: Risk Factors For Progression Of Beta-cell Dysfunction In Spiddmmentioning

confidence: 99%

<p>Slowly Progressive Type 1 Diabetes Mellitus: Current Knowledge And Future Perspectives</p>

Nishimura¹,

Matsumura²,

Kikuno³

et al. 2019

DMSO

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show abstract

“…A positive correlation was reported between BMI and insulin secretion [25]; therefore, BMI may reflect the insulin secretory capacity, and patients with a low BMI may have poor insulin secretory capacity. Moreover, non-obese (BMI < 22 kg/m 2 ) Japanese patients with SPIDDM are reportedly more likely to possess high-risk HLA genotypes for type 1 diabetes compared with obese (BMI ≥ 25 kg/m 2 ) patients with SPIDDM [26]. Furthermore, resistant HLA genotypes for type 1 diabetes were associated with higher BMI in patients with LADA [27,28].…”

Section: Discussionmentioning

confidence: 97%

Adult-onset autoimmune diabetes identified by glutamic acid decarboxylase autoantibodies: a retrospective cohort study

et al. 2021

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Aims/hypothesis Patients with GAD antibodies (GADAb) showing clinical features of type 2 diabetes typically exhibit progression to an insulin-dependent state in several months or years. This condition is diagnosed as slowly progressive insulin-dependent (type 1) diabetes mellitus (SPIDDM) or latent autoimmune diabetes in adults, a subtype of adult-onset autoimmune diabetes. However, some patients diagnosed with adult-onset autoimmune diabetes do not progress to an insulin-dependent state. We conducted a retrospective cohort study to identify patients with non-insulin-dependent diabetes among those diagnosed with adult-onset autoimmune diabetes using measurable indicators in routine clinical practice. Methods We surveyed data from the electronic medical records of all patients with GADAb from eight medical centres in Japan for selecting and analysing patients who matched the diagnostic criteria of SPIDDM. Results Overall, 345 patients were analysed; of these, 162 initiated insulin therapy (insulin therapy group), whereas 183 did not (noninsulin therapy group) during the follow-up period (median 3.0 years). Patients in the non-insulin therapy group were more likely to be male and presented a later diabetes onset, shorter duration of diabetes, higher BMI, higher blood pressure levels, lower HbA 1c levels, lower GADAb levels and lesser antidiabetic agent use than those in the insulin therapy group when GADAb was first identified as positive. A Cox proportional hazards model showed that BMI, HbA 1c levels and GADAb levels were independent factors for progression to insulin therapy. Kaplan-Meier analyses revealed that 86.0% of the patients with diabetes having GADAb who presented all three factors (BMI ≥ 22 kg/m 2 , HbA 1c < 75 mmol/mol [9.0%] and GADAb <10.0 U/ml) did not require insulin therapy for 4 years. Conclusions/interpretation Higher BMI (≥22 kg/m 2 ), lower HbA 1c (<75 mmol/mol [9.0%]) and lower GADAb levels (<10.0 U/ ml) can predict a non-insulin-dependent state for at least several years in Japanese patients with diabetes having GADAb.Keywords Adult-onset autoimmune diabetes . Glutamic acid decarboxylase antibody . Latent autoimmune diabetes in adults . Non-insulin-dependent . Slowly progressive insulin-dependent (type 1) diabetes mellitus Abbreviations GADAb GAD antibodies LADA Latent autoimmune diabetes in adults ROC Receiver operating characteristic SPIDDM Slowly progressive insulin-dependent (type 1) diabetes mellitus

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Association Between HLA Polymorphisms and Sympathetic Ophthalmia in Han Chinese

Zhao

Cao

Zhou

et al. 2023

Ocular Immunology and Inflammation

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Relationship between HLA haplotype and BMI change in Japanese slowly progressive type 1 diabetes patients

Cited by 3 publications

References 9 publications

<p>Slowly Progressive Type 1 Diabetes Mellitus: Current Knowledge And Future Perspectives</p>

<p>Slowly Progressive Type 1 Diabetes Mellitus: Current Knowledge And Future Perspectives</p>

Adult-onset autoimmune diabetes identified by glutamic acid decarboxylase autoantibodies: a retrospective cohort study

Association Between HLA Polymorphisms and Sympathetic Ophthalmia in Han Chinese

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