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J Diabetes Investig. 2019 Nov 22. doi: 10.1111/jdi.13184. [Epub ahead of print]

Increased diagnosis of autoimmune childhood-onset Japanese type 1 diabetes using a new GADAb ELISA kit, compared with a previously used GADAb RIA kit.

Author information

1
Department of Pediatrics, Tokyo Women's Medical University Medical Center East, Tokyo.
2
Department of Pediatric Endocrinology and Metabolism, Shikoku Medical Center for Children and Adults, Kagawa.
3
Department of Pediatrics, Asahikawa-Kosei General Hospital, Asahikawa.
4
Department of Pediatrics, Osaka Police Hospital, Osaka.
5
Mominoki Hospital, Kochi.
6
Department of Pediatrics, Tokyo Women's Medical University Hospital, Tokyo.
7
Department of Pediatrics, Kyushu Rousai Hospital, Kitakyushu.
8
Department of Pediatrics, Teikyo University Chiba Medical Center, Chiba.
9
Department of Pediatrics, Yokohama City Minato Red Cross Hospital, Yokohama.
10
Department of Pediatrics, Nihon University School of Medicine, Tokyo.
11
Department of Pediatrics, Osaka City University School of Medicine, Osaka.
12
Department of Diabetes and Endocrinology, Shin-Koga Hospital, Kurume.
13
Department of Pediatrics, Saitama Medical University, Iruma, Saitama, Japan.

Abstract

AIMS/INTRODUCTION:

We compared the results of testing for glutamic acid decarboxylase antibodies (GADAb) using a radioimmunoassay (RIA) and an enzyme-linked immunosorbent assay (ELISA) in subjects with childhood-onset type 1 diabetes mellitus (T1D).

MATERIALS AND METHODS:

Serum specimens were collected from 1024 Japanese cases (426 boys and 598 girls) in 2013. The median age at diagnosis was 7 years (0-18 years). The blood specimens were obtained at a median age of 13 years (2-22 years).

RESULTS:

Among the 628 subjects whose serum specimens were collected within 5 years after diagnosis, the rate of GADAb positivity was 47.9% using RIA and 69.4% using ELISA. The subjects were divided into four groups according to their RIA and ELISA results for GADAb as follows: Gr I (RIA+/ELISA+), Gr II (RIA+/ELISA-), Gr III (RIA-/ELISA+), and Gr IV (RIA-/ELISA-). The clinical and genetic characteristics of Gr I and Gr III were quite similar in terms of age at diagnosis, male/female ratio, relatively high positive rates for both IA-2Ab and ZnT8Ab, and HLA genotype. Gr II contained only 5 patients and was characterized by a younger age at diagnosis, low positive rates for both IA-2Ab and ZnT8Ab, and a unique HLA genotype. If the positive rates of either IA-2Ab or ZnT8Ab or both were added to the GADAb results using RIA, the percentage of autoimmune T1D increased from 47.9% to 78.5%.

CONCLUSION:

The diagnosis of autoimmune childhood-onset Japanese T1D increased when GADAb results were obtained using a new ELISA method, compared with a previously utilized RIA method.

KEYWORDS:

enzyme-linked immunosorbent assay (ELISA); glutamic decarboxylase antibody (GADAb); radioimmunoassay (RIA)

PMID:
31756289
DOI:
10.1111/jdi.13184
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