Diabetologia

, Volume 37, Issue 11, pp 1113–1120

Anti-glutamate decarboxylase and other antibodies at the onset of childhood IDDM: a population-based study

  • C. F. Verge
  • N. J. Howard
  • M. J. Rowley
  • I. R. Mackay
  • P. Z. Zimmet
  • M. Egan
  • H. Hulinska
  • I. Hulinsky
  • R. A. Silvestrini
  • S. Kamath
  • A. Sharp
  • T. Arundel
  • M. Silink
Originals

DOI: 10.1007/BF00418375

Cite this article as:
Verge, C.F., Howard, N.J., Rowley, M.J. et al. Diabetologia (1994) 37: 1113. doi:10.1007/BF00418375
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Summary

Sera obtained at diagnosis from 273 children (0–14 years) with insulin-dependent diabetes mellitus (IDDM) were studied to compare different autoantibody levels. The subjects comprise 75% of all incident cases in New South Wales, Australia, for a 2-year period (ascertainment >99% complete). Antibodies against glutamate decarboxylase were measured by radioimmunoprecipitation, insulin autoantibodies (on 176 sera collected within 4 days of initiation of insulin therapy) by radioimmunoassay, thyroid peroxidase and antigliadin IgA antibodies by enzyme-linked immunoassay, and anti-endomysial IgA and islet cell antibodies by indirect immunofluorescence. Reference ranges for anti-glutamate decarboxylase and insulin autoantibodies were determined in a group of non-diabetic children. Of the sera 69% were positive for anti-glutamate decarboxylase, 65% for insulin autoantibodies, 71% for islet cell antibodies (⩾20 Juvenile Diabetes Foundation units), 10% for anti-thyroid peroxidase, 2.6% for antigliadin and 3.0% for anti-endomysial antibodies. Islet cell antibodies and insulin autoantibodies were both negative in 13.7% of the sera, while only 5.8% were negative for all three of islet cell antibodies, insulin autoantibodies and anti-glutamate decarboxylase. There was a higher frequency of anti-glutamate decarboxylase among girls than boys (75% vs 63%, p=0.03) and a negative correlation between the level of insulin autoantibodies and age at diagnosis (r=−0.41, p<0.0001). A higher frequency of antithyroid peroxidase was found with increasing age (p=0.05). Higher titres of islet cell antibodies were associated with a higher frequency of both anti-glutamate decarboxylase (p<0.0001) and insulin autoantibodies (p=0.003). Five children (1.8%) with clear elevations of antigliadin and anti-endomysial antibodies were found to have asymptomatic coeliac disease by small bowel biopsy.

Key words

Autoantibodies glutamate decarboxylase islet cell antibodies insulin thyroid peroxidase coeliac disease 

Abbreviations

IDDM

insulin-dependent diabetes mellitus

ICA

islet cell antibodies

IAA

insulin autoantibodies

anti-GAD

antibodies against glutamate decarboxylase

anti-TPO

antibodies against thyroid peroxidase

AGA

antigliadin IgA antibodies

AEA

anti-endomysial antibodies

JDF U

Juvenile Diabetes Foundation units

PBS

phosphate buffered saline

Copyright information

© Springer-Verlag 1994

Authors and Affiliations

  • C. F. Verge
    • 1
  • N. J. Howard
    • 1
  • M. J. Rowley
    • 2
  • I. R. Mackay
    • 2
  • P. Z. Zimmet
    • 3
  • M. Egan
    • 1
  • H. Hulinska
    • 1
  • I. Hulinsky
    • 1
  • R. A. Silvestrini
    • 4
  • S. Kamath
    • 4
  • A. Sharp
    • 5
  • T. Arundel
    • 1
  • M. Silink
    • 1
  1. 1.Ray Williams Institute for Paediatric EndocrinologyRoyal Alexandra Hospital for ChildrenSydneyAustralia
  2. 2.Centre for Molecular BiologyMonash UniversityClaytonAustralia
  3. 3.International Diabetes InstituteCaulfieldAustralia
  4. 4.Institute of Clinical Pathology and Medical ResearchWestmead HospitalSydneyAustralia
  5. 5.Rodney Shearman Endocrinology LaboratoryRoyal Prince Alfred HospitalSydneyAustralia
  6. 6.Barbara Davis Center for Childhood DiabetesUniversity of Colorado Health Sciences CenterDenverUSA

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