Davis T M, Zimmet P, Davis W A, Bruce D G, Fida S, Mackay I R
University of Western Australia, Department of Medicine, Fremantle Hospital, Australia.
Diabet Med. 2000 Sep;17(9):667-74. doi: 10.1046/j.1464-5491.2000.00359.x.
To investigate ethnic/racial differences in the prevalence of serum antibodies to glutamic acid decarboxylase (GADA) and ICA512/IA-2 in diabetic patients from a large, urban community.
A cross-sectional sample of 1,381 diabetic patients aged 11-98 years, representing 61% of those identified in a postcode-defined population base of 120,097 people were studied. Diabetes was classified on clinical grounds. Serum GADA and anti-ICA512/IA-2 were measured by radioimmunoprecipitation assay.
Anglo-Celts formed 62% of the sample, southern Europeans 18%, other Europeans 8% and Asians 3%. GADA prevalence in Type 1 and Type 2 diabetes mellitus was 46.0% and 4.2%, respectively, amongst Anglo-Celts and 22.2% and 1.7% in southern Europeans. The prevalence of anti-ICA512/IA-2 in Type 1 diabetes was 17.4% and, in a sample of 233 patients with Type 2 diabetes, 0.8%. GADA-positive Type 2 patients had a lower body mass index and greater glycosylated haemoglobin, and were more likely to be taking insulin, than GADA-negative Type 2 diabetic subjects (P < 0.05), consistent with the phentoype of latent autoimmune diabetes of adults (LADA). In both Type 1 and Type 2 diabetes, there was a strong inverse association between GADA and serum triglycerides (P < 0.001).
The relatively low GADA prevalence in Anglo-Celt patients with Type 1 diabetes is a feature of this community-based study and suggests that GADA levels do fall with time, given the older age of the sample and a relatively long period between diagnosis and sampling. Southern Europeans had an even lower GADA prevalence, regardless of diabetes type. Variations in GADA frequency in diabetic patients of differing European ethnicity has implications for clinical management and healthcare planning.
调查来自一个大型城市社区的糖尿病患者中，谷氨酸脱羧酶（GADA）和胰岛细胞抗原512/胰岛素瘤相关蛋白2（ICA512/IA-2）血清抗体患病率的种族差异。
对1381例年龄在11 - 98岁的糖尿病患者进行横断面抽样研究，这些患者占一个邮政编码界定的120097人总体人群中所识别患者的61%。糖尿病按临床标准分类。采用放射免疫沉淀法检测血清GADA和抗ICA512/IA-2。
样本中盎格鲁 - 凯尔特人占62%，南欧人占18%，其他欧洲人占8%，亚洲人占3%。在1型和2型糖尿病中，盎格鲁 - 凯尔特人中GADA患病率分别为46.0%和4.2%，南欧人中分别为22.2%和1.7%。1型糖尿病中抗ICA512/IA-2患病率为17.4%，在233例2型糖尿病患者样本中为0.8%。与GADA阴性的2型糖尿病患者相比，GADA阳性的2型患者体重指数较低、糖化血红蛋白较高，且更可能正在使用胰岛素（P < 0.05），这与成人隐匿性自身免疫性糖尿病（LADA）的表型一致。在1型和2型糖尿病中，GADA与血清甘油三酯之间均存在强烈的负相关（P < 0.001）。
在这项基于社区的研究中，盎格鲁 - 凯尔特人1型糖尿病患者中GADA患病率相对较低，鉴于样本年龄较大且诊断与采样之间间隔时间较长，这表明GADA水平确实会随时间下降。无论糖尿病类型如何，南欧人的GADA患病率更低。不同欧洲种族的糖尿病患者中GADA频率的差异对临床管理和医疗保健规划具有重要意义。
