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Sci China Life Sci. 2016 Sep;59(9):930-9. doi: 10.1007/s11427-016-5052-3. Epub 2016 May 25.

The heterogeneity of islet autoantibodies and the progression of islet failure in type 1 diabetic patients.

Liu J1, Bian L1, Ji L1, Chen Y1, Chen H1, Gu Y1, Ma B1, Gu W2, Xu X1, Shi Y1, Wang J3, Zhu D4, Sun Z5, Ma J6, Jin H5, Shi X2, Miao H7, Xin B8, Zhu Y9, Zhang Z9, Bu R10, Xu L10, Shi G11, Tang W11, Li W12, Zhou D12, Liang J13, Cheng X14, Shi B14, Dong J15, Hu J15, Fang C15, Zhong S16, Yu W17, Lu W18, Wu C19, Qian L19, Yu J20, Gao J21, Fei X21, Zhang Q21, Wang X22, Cui S23, Cheng J24, Xu N25, Wang G25, Han G26, Xu C27, Xie Y28, An M29, Zhang W29, Wang Z1, Cai Y1, Fu Q1, Fu Y1, Zheng S1, Yang F1, Hu Q1, Dai H1, Jin Y1, Zhang Z1, Xu K1, Li Y30, Shen J31, Zhou H1, He W1, Zheng X1, Han X32, Yu L33, She J34, Zhang M35, Yang T36,37.

Author information

1
Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
2
Department of Endocrinology and Metabolism, Nanjing Children's Hospital, Nanjing, 210008, China.
3
Department of Endocrinology and Metabolism, Nanjing General Hospital of Nanjing Military Command, Nanjing, 210002, China.
4
Department of Endocrinology and Metabolism, Nanjing Drum Tower Hospital The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
5
Department of Endocrinology and Metabolism, Zhongda Hospital Southeast University, Nanjing, 210009, China.
6
Department of Endocrinology and Metabolism, Nanjing First Hospital, Nanjing, 210000, China.
7
Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, 210011, China.
8
Department of Endocrinology and Metabolism, Nanjing Governmental Hospital, Nanjing, 210008, China.
9
Department of Endocrinology and Metabolism, Northern Jiangsu People's Hospital, Yangzhou, 225001, China.
10
Department of Endocrinology and Metabolism, Wuxi People's Hospital, Wuxi, 214023, China.
11
Department of Endocrinology and Metabolism, Jiangsu Jiangyin People's Hospital, Wuxi, 214400, China.
12
Department of Endocrinology and Metabolism, The Affiliated Hospital of Xuzhou Medical College, Xuzhou, 221006, China.
13
Department of Endocrinology and Metabolism, Xuzhou Central Hospital, Xuzhou, 221009, China.
14
Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China.
15
Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China.
16
Department of Endocrinology and Metabolism, The First People's Hospital of Kunshan, Suzhou, 215300, China.
17
Department of Endocrinology and Metabolism, Huai'an Second People's Hospital, Huai'an, 223002, China.
18
Department of Endocrinology and Metabolism, Huai'an First People's Hospital, Huai'an, 223300, China.
19
Department of Endocrinology and Metabolism, The First People's Hospital of Zhenjiang, Zhenjiang, 212002, China.
20
Department of Endocrinology and Metabolism, Yancheng City No.1 People's Hospital, Yancheng, 224005, China.
21
Department of Endocrinology and Metabolism, Jiangsu Taizhou People's Hospital, Taizhou, 225300, China.
22
Department of Endocrinology and Metabolism, The First People's Hospital of Nantong, Nantong, 226000, China.
23
Department of Endocrinology and Metabolism, Affiliated Hospital of Nantong University, Nantong, 226001, China.
24
Department of Endocrinology and Metabolism, Changzhou No. 2 People's Hospital, Changzhou, 213003, China.
25
Department of Endocrinology and Metabolism, The First People's Hospital of Lianyungang, Lianyungang, 222002, China.
26
Department of Endocrinology and Metabolism, Binhai People's Hospital of Yancheng City, Yancheng, 224500, China.
27
Department of Endocrinology and Metabolism, Xuzhou Tumor Hospital, Xuzhou, 221005, China.
28
Department of Endocrinology and Metabolism, Tianjin Medical University Metabolic Disease Hospital, Tianjin, 300070, China.
29
Department of Endocrinology and Metabolism, Wuhu No.2 People's Hospital, Wuhu, 241000, China.
30
Department of Isotopic Laboratory of Nanjing Medical University, Nanjing, 210000, China.
31
HLA Laboratory of Jiangsu Province People's Hospital, Nanjing, 210029, China.
32
Key Laboratory of Human Functional Genomics of Jiangsu Province, Nanjing Medical University, Nanjing, 210000, China.
33
Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, Aurora, Colorado, 80045, USA.
34
Center for Biotechnology and Genomic Medicine, Medical College of Georgia, GA Regents University, Augusta, 30912, USA.
35
Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China. zhangmei@njmu.edu.cn.
36
Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China. yangt@njmu.edu.cn.
37
Key Laboratory of Human Functional Genomics of Jiangsu Province, Nanjing Medical University, Nanjing, 210000, China. yangt@njmu.edu.cn.

Abstract

Type 1 diabetes mellitus is heterogeneous in many facets. The patients suffered from type 1 diabetes present several levels of islet function as well as variable number and type of islet-specific autoantibodies. This study was to investigate prevalence and heterogeneity of the islet autoantibodies and clinical phenotypes of type 1 diabetes mellitus; and also discussed the process of islet failure and its risk factors in Chinese type 1 diabetic patients. A total of 1,291 type 1 diabetic patients were enrolled in this study. Demographic information was collected. Laboratory tests including mixed-meal tolerance test, human leukocyte antigen alleles, hemoglobinA1c, lipids, thyroid function and islet autoantibodies were conducted. The frequency of islet-specific autoantibody in newly diagnosed T1DM patients (duration shorter than half year) was 73% in East China. According to binary logistic regressions, autoantibody positivity, longer duration and lower Body Mass Index were the risk factors of islet failure. As the disease developed, autoantibodies against glutamic acid decarboxylase declined as well as the other two autoantibodies against zinc transporter 8 and islet antigen 2. The decrease of autoantibodies was positively correlated with aggressive beta cell destruction. Autoantibodies can facilitate the identification of classic T1DM from other subtypes and predict the progression of islet failure. As there were obvious heterogeneity in autoantibodies and clinical manifestation in different phenotypes of the disease, we should take more factors into consideration when identifying type 1 diabetes mellitus.

KEYWORDS:

autoantibodies; heterogeneity; islet failure; type 1 diabetes

PMID:
27225179
DOI:
10.1007/s11427-016-5052-3
[Indexed for MEDLINE]

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