Glutamic acid decarboxylase antibodies are indicators of the course, but not of the onset, of diabetes in middle-aged adults: the Atherosclerosis Risk in Communities Study
Título del documento: Glutamic acid decarboxylase antibodies are indicators of the course, but not of the onset, of diabetes in middle-aged adults: the Atherosclerosis Risk in Communities Study
Revista: Brazilian journal of medical and biological research
Base de datos: PERIÓDICA
Número de sistema: 000350916
ISSN: 0100-879X
Autores: 1
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2
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Instituciones: 1Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Porto Alegre, Rio Grande do Sul. Brasil
2University of North Carolina, School of Public Health, Chapel Hill, Carolina del Norte. Estados Unidos de América
3University of Minnesota, School of Public Health, Minneapolis, Minnesota. Estados Unidos de América
4Baylor University, Baylor College of Medicine, Houston, Texas. Estados Unidos de América
Año:
Periodo: Jul
Volumen: 40
Número: 7
Paginación: 933-941
País: Brasil
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Experimental, aplicado
Resumen en inglés To efficiently examine the association of glutamic acid decarboxylase antibody (GADA) positivity with the onset and progression of diabetes in middle-aged adults, we performed a case-cohort study representing the ~9-year experience of 10,275 Atherosclerosis Risk in Communities Study participants, initially aged 45-64 years. Antibodies to glutamic acid decarboxylase (GAD 65 ) were measured by radioimmunoassay in 580 incident diabetes cases and 544 non-cases. The overall weighted prevalence of GADA positivity (³1 U/mL) was 7.3%. Baseline risk factors, with the exception of smoking and interleukin-6 (P £ 0.02), were generally similar between GADA-positive and -negative individuals. GADA positivity did not predict incident diabetes in multiply adjusted (HR = 1.04; 95%CI = 0.55, 1.96) proportional hazard analyses. However, a small non-significant adjusted risk (HR = 1.29; 95%CI = 0.58, 2.88) was seen for those in the highest tertile (³2.38 U/mL) of positivity. GADA-positive and GADA-negative non-diabetic individuals had similar risk profiles for diabetes, with central obesity and elevated inflammation markers, aside from glucose, being the main predictors. Among diabetes cases at study's end, progression to insulin treatment increased monotonically as a function of baseline GADA level. Overall, being GADA positive increased risk of progression to insulin use almost 10 times (HR = 9.9; 95%CI = 3.4, 28.5). In conclusion, in initially non-diabetic middle-aged adults, GADA positivity did not increase diabetes risk, and the overall baseline profile of risk factors was similar for positive and negative individuals. Among middle-aged adults, with the possible exception of those with the highest GADA levels, autoimmune pathophysiology reflected by GADA may become clinically relevant only after diabetes onset
Disciplinas: Medicina
Palabras clave: Metabolismo,
Inmunología,
Diabetes,
Acido glutamico descarboxilasa,
Anticuerpos,
Enfermedades autoinmunes,
Inflamación,
Factores de riesgo
Keyword: Medicine,
Metabolism,
Immunology,
Diabetes,
Glutamic acid decarboxylase,
Antibodies,
Autoimmune diseases,
Inflammation,
Risk factors
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