Diabetologia

, Volume 44, Issue 8, pp 1005–1010

Titre and combination of ICA and autoantibodies to glutamic acid decarboxylase discriminate two clinically distinct types of latent autoimmune diabetes in adults (LADA)

Authors

  • T. Lohmann
    • Department of Internal Medicine III, University of Leipzig, Leipzig, Germany
  • K. Kellner
    • Department of Internal Medicine III, University of Leipzig, Leipzig, Germany
  • H.-J. Verlohren
    • Diabetes Speciality Practice, Leipzig, Germany
  • J. Krug
    • City Hospital Leipzig, Leipzig, Germany
  • J. Steindorf
    • City Hospital Leipzig, Leipzig, Germany
  • W. A. Scherbaum
    • German Diabetes Research Institute, University of Düsseldorf, Düsseldorf, Germany
  • J. Seissler
    • German Diabetes Research Institute, University of Düsseldorf, Düsseldorf, Germany
Article

DOI: 10.1007/s001250100602

Cite this article as:
Lohmann, T., Kellner, K., Verlohren, H. et al. Diabetologia (2001) 44: 1005. doi:10.1007/s001250100602

Abstract

Aims/hypothesis:

This study aimed to define the immunological parameters which could be used to identify patients with the distinct metabolic features of adult latent autoimmune diabetes.

Methods:

Sera of 312 patients with short-term diabetes (duration < 5 years) over 35 years of age at diagnosis were screened for ICA, GAD- and IA2-Ab by antibody assays validated in workshops. The antibody status was correlated with age, BMI, residual beta-cell function, measured by fasting C-peptide, onset of diabetes-related complications and markers of the metabolic syndrome (hypertension and hyperlipidaemia).

Results:

A total of 51 antibody positive patients were identified. These patients had lower fasting C-peptide and less neuropathy and hypertension compared with matched antibody-negative patients. However, only patients with two or more antibodies had reduced residual beta-cell function compared with antibody-negative or single antibody-positive (ICA or GAD-Ab only) patients. Patients with two or more antibodies were also leaner and had diabetes-related complications or hypertension less frequently than single antibody-positive or antibody negative-patients. IA2 antibody status did not substantially contribute to the diagnosis or differentiation of LADA patients.

Conclusion/interpretation:

We concluded that the combination of ICA and GAD antibodies and high titre of GAD antibodies are characteristic of patients with insulin deficiency with the clinical features of Type I (insulin-dependent) diabetes mellitus (LADA-type 1). Single antibody positivity and low titre antibodies are markers for LADA-type 2 associated with the clinical and metabolic phenotype of Type II (non-insulin-dependent) diabetes patients. [Diabetologia (2001) 44: 1005–1010]

Keywords GAD-Ab ICA diabetes mellitus LADA.

Copyright information

© Springer-Verlag Berlin Heidelberg 2001