Evidence of islet cell autoimmunity in elderly patients with type 2 diabetes.
Open accessAbstract
In light of an occurring growth of elderly people affected by type 2 diabetes and recent observations indicating that type 2 diabetes may be a disease of the innate immune system, we evaluated whether signs of islet cell autoimmunity are associated with an abnormal glucose control, the presence of insulin requirement, or an activation of the acute-phase response in older individuals with type 2 diabetes. GAD65 and IA-2 autoantibodies along with the acute-phase response markers fibrinogen and C-reactive protein were tested in 196 serum samples from patients with type 2 diabetes and in 94 nondiabetic control subjects over the age of 65 years from the Pittsburgh cohort of the Cardiovascular Health Study. Of the diabetic patients, 12% (24 of 196) had autoantibodies against GAD65 and/or IA-2, a prevalence significantly higher than that found in nondiabetic individuals (1 of 94, 1.1%; P = 0.001). Type 2 diabetic patients who were positive for GAD65 and/or IA-2 autoantibodies (Ab+), as compared with those negative for these autoantibodies (Ab-), had an abnormal oral glucose tolerance test (OGTT) (P = 0.03) before and a higher frequency of oral hypoglycemic treatment (P = 0.003) at the time of autoantibody testing. No differences were seen in the percentage of insulin requirement in the two groups. Moreover, a statistically significant increase in fibrinogen (P = 0.005) and C-reactive protein levels (P = 0.025) was found in type 2 diabetic patients with high levels of GAD65 and/or IA-2 autoantibodies as compared with Ab-patients and control subjects. In conclusion, in type 2 diabetic subjects > or =65 years old, the presence of islet cell autoimmunity is associated with an impairment of the acute-phase insulin secretion, as revealed by an OGTT. A pronounced activation of the acute-phase response, found to be associated with islet cell autoimmunity, may in part explain this defect in insulin secretion. These findings not only have direct implications for adequate classification and treatment of diabetes in the elderly, but also for understanding the autoimmune/inflammatory mechanisms involved in the pathogenesis of hyperglycemia.
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One study found that 12% of T2D patients screened for islet autoantibodies were positive for at least one islet autoantibody.
“One study found that 12% of T2D patients screened for islet autoantibodies were positive for at least one islet autoantibody.314”
From A review of current trends with type 2 diabetes epidemiology, aetiology, pathogenesis, treatments and future perspectives (2021) · cites this paper as [314]
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- Authors
- Pietropaolo, M., Barinas-Mitchell, E., Pietropaolo, S. L., Kuller, L. H., & Trucco, M.
- Affiliations
- University of Pittsburgh (US)
- Department of Pediatrics, Rangos Research Center, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pennsylvania 15213, USA. pietroma+@pitt.edu
- Corresponding author
- Pietropaolo, M
- Pietropaolo, S L
- Trucco, M
- Venue
- Diabetes
- Publisher
- American Diabetes Association
- Published
- 2000-01-01
- Volume
- 49
- Issue
- 1
- Pages
- 32-38
- ISSN
- 0012-1797 (ISSN-L)
- 1939-327X
- OpenAlex
- W2158247206
- Cited by
- 159
- References
- 21
- Citations by year
- 2024: 4 · 2023: 6 · 2022: 1 · 2021: 1 · 2020: 3 · 2019: 7 · 2018: 4 · 2017: 4 · 2016: 3 · 2015: 5 · 2014: 8 · 2013: 6 · 2012: 2
- FWCI
- 8.74
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Diabetes Association
- National Institutes of Health (n01hc085082-026, 07011, N01-HC-85082)
- National Heart, Lung, and Blood Institute (HL 07011, N01HC85082)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK053456, R01 DK53456)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- type 2 diabetes, islet autoimmunity, elderly patients, GAD65 antibodies, IA-2 autoantibodies, acute phase response, C-reactive protein, fibrinogen, oral glucose tolerance, insulin secretion, innate immunity
- MeSH terms
- Aged, Aged, 80 and over, Aging, Autoantibodies, Autoantigens, Blood Glucose, C-Reactive Protein, Diabetes Mellitus, Type 2, Female, Fibrinogen, Glucose Tolerance Test, Glutamate Decarboxylase, Humans, Islets of Langerhans, Male, Membrane Proteins, Autoimmunity, Protein Tyrosine Phosphatases, Receptor-Like Protein Tyrosine Phosphatases, Class 8
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