Jónsdóttir Anna Margrét, Aspelund Thor, Sigurdsson Gunnar, Gudnason Vilmundur, Benediktsson Rafn
Department of Endocrine and Metabolic Diseases, Iceland University Hospital, Fossvogi, 108 Reykjavík, Iceland.
Laeknabladid. 2005 Dec;91(12):909-14.
Ninety percent of diabetic individuals in Iceland suffer from type 2 diabetes mellitus. Antibodies against ss-cell components characterise type 1 diabetes, but these antibodies are also found in type 2 diabetic individuals, defined as latent autoimmune diabetes in adults or LADA. The purpose of this investigation was to estimate the prevalence of LADA in Iceland and to describe the phenotype and relatedness of these individuals.
A list of individuals diagnosed with type 2 diabetes was generated from outpatient clinic lists and the Reykjavik Study of the Icelandic Heart Association. A genealogy database (Book of Icelanders; deCODE Genetics) was used to identify all individuals related to these index cases within six meioses. This method identified 950 type 2 diabetic individuals during the years 1998-2000. We analyzed their phenotype and measured glutamic acid decarboxylase antibody (GAD). Kinship coefficient was used to compare the relatedness of those with antibodies to GAD to the relatedness of all type 2 diabetic individuals in the study.
10.1% of men and 9.3% women had measurable antibodies against GAD (non-significant difference). The mean age of GAD positive and GAD negative individuals was comparable (67.1 +/- 10.7 and 68.0 +/- 11.3; years +/- SD). Body mass index was significantly lower (p=0,02) for the GAD positive individuals or 28.2 kg/m(2) (27.2-29.2; 95% CI) vs. 29.7 (29.3-30.1). Of the GAD positive individuals, 47% +/- 9% (95% CI) had the metabolic syndrome as defined by WHO compared with 60 +/- 4% of the GAD negative individuals (p=0.02). The kinship coefficient for GAD positive individuals (n=94) was 6.00x10(-4) compared with 3.93x10(-4) +/- 8.3x10(-5) for 500 random samples (each of 94 individuals) of the whole cohort (p=0.008).
About 10% of Icelandic type 2 diabetic individuals have antibodies against GAD, which is comparable to the results of other investigators. Icelandic GAD positive type 2 diabetic individuals have less frequently the metabolic syndrome than other type 2 diabetic individuals and GAD positive individuals are significantly more related to each other than type 2 diabetic individuals in general.
冰岛90%的糖尿病患者患有2型糖尿病。针对β细胞成分的抗体是1型糖尿病的特征，但这些抗体在2型糖尿病患者中也有发现，这类患者被定义为成人隐匿性自身免疫性糖尿病（LADA）。本研究的目的是评估冰岛LADA的患病率，并描述这些个体的表型及亲缘关系。
从门诊病历及冰岛心脏协会的雷克雅未克研究中获取被诊断为2型糖尿病的个体名单。利用一个族谱数据库（冰岛人族谱；deCODE基因公司）来识别在六代以内与这些索引病例相关的所有个体。该方法在1998年至2000年期间识别出950名2型糖尿病患者。我们分析了他们的表型并检测了谷氨酸脱羧酶抗体（GAD）。亲缘系数用于比较GAD抗体阳性者与研究中所有2型糖尿病患者的亲缘关系。
10.1%的男性和9.3%的女性有可检测到的抗GAD抗体（差异无统计学意义）。GAD抗体阳性和阴性个体的平均年龄相近（分别为67.1±10.7岁和68.0±11.3岁；岁±标准差）。GAD抗体阳性个体的体重指数显著更低（p=0.02），为28.2kg/m²（27.2 - 29.2；95%置信区间），而GAD抗体阴性个体为29.7（29.3 - 30.1）。在GAD抗体阳性个体中，47%±9%（95%置信区间）符合世界卫生组织定义的代谢综合征，而GAD抗体阴性个体中这一比例为60±4%（p=0.02）。GAD抗体阳性个体（n = 94）的亲缘系数为6.00×10⁻⁴，而整个队列500个随机样本（每个样本94人）的亲缘系数为3.93×10⁻⁴±8.3×10⁻⁵（p=0.008）。
约10%的冰岛2型糖尿病患者有抗GAD抗体，这与其他研究者的结果相近。冰岛GAD抗体阳性的2型糖尿病患者患代谢综合征的频率低于其他2型糖尿病患者，且GAD抗体阳性个体之间的亲缘关系显著高于一般2型糖尿病患者。
