학술논문
Islet Autoimmunity is Highly Prevalent and Associated With Diminished β-Cell Function in Patients With Type 2 Diabetes in the Grade Study.
Document Type
article
Author
Brooks-Worrell, Barbara; Hampe, Christiane S; Hattery, Erica G; Palomino, Brenda; Zangeneh, Sahar Z; Utzschneider, Kristina; Kahn, Steven E; Larkin, Mary E; Johnson, Mary L; Mather, Kieren J; Younes, Naji; Rasouli, Neda; Desouza, Cyrus; Cohen, Robert M; Park, Jean Y; Florez, Hermes J; Valencia, Willy Marcos; Shojaie, Ali; Palmer, Jerry P; Balasubramanyam, Ashok; Crandall, Jill P; McKee, Melissa Diane; Brown-Friday, Janet; Xhori, Entila; Ballentine-Cargill, Keisha; Duran, Sally; Lukin, Jennifer; Beringher, Stephanie; Gonzalez de la Torre, Susana; Phillips, Lawrence; Burgess, Elizabeth; Olson, Darin; Rhee, Mary; Wilson, Peter; Raines, Tasha Stephanie; Costello, Julie; Gullett, Chona; Maher-Albertelli, Maxine; Morehead, Folayan; Mungara, Radhika; Person, Saranjit; Savoye, Louise; Sibymon, Mabil; Tanukonda, Sridhar; White, Carol Ann; Holloway, Leah; Adams, Cynthia; Ross, April; Gonzalez Hattery, Erica; Gaba, Ruchi; Montes, Graciela; Wright, Charlyne; Hollander, Priscilla; Roe, Erin; Uy, Analyn; Burt, Polly; Estrada, Lorie; Chionh, Kris; Ismail-Beigi, Faramarz; Falck-Ytter, Corinna; Sayyed Kassem, Laure; Sood, Ajay; Tiktin, Margaret; Cramer, Bethany; Iacoboni, Jacalyn; Kononets, Maria V; Kulow, Tanya; Newman, Cynthia; Stancil, Katherine A; Sanders, Cristina; Tucker, Lisa; Werner, Amanda; Krol, Adrienne; McPhee, Gloria; Patel, Christine; Colosimo, Linda; Goland, Robin; Pring, James; Kringas, Patricia; Tejada, Jessica; Hausheer, Camille; Schneier, Harvey; Gumpel, Kelly; Kirpitch, Amanda; Green, Jennifer B; AbouAssi, Hiba; Chatterjee, Ranee; Feinglos, Mark N; English Jones, Jennifer; Khan, Shubi A; Kimpel, Jeanne B; Zimmer, Ronna P; Furst, Mary; Satterwhite, Barbara M; Thacker, Connie; Evans Kreider, Kathryn; Lteif, Amale; Hamilton, Tonya
Source
Diabetes. 71(6)
Subject
Language
Abstract
Islet autoimmunity may contribute to β-cell dysfunction in type 2 diabetes (T2D). Its prevalence and clinical significance have not been rigorously determined. In this ancillary study to the Glycemia Reduction Approaches in Diabetes-A Comparative Effectiveness (GRADE) Study, we investigated the prevalence of cellular and humoral islet autoimmunity in patients with T2D duration 4·0±3·0 y, HbA1c 7·5±0·5% on metformin alone. We measured T cell autoreactivity against islet proteins, islet autoantibodies against GAD65, IA2, ZnT8, and β-cell function. Cellular islet autoimmunity was present in 41·3%, humoral islet autoimmunity in 13·5%, and both in 5·3%. β-cell function calculated as iAUC-CG and ΔC-peptide(0- 30)/Δglucose(0-30) from an oral glucose tolerance test was lower among T cell-positives (T+) than T cell-negatives (T-) using two different adjustments for insulin sensitivity (iAUC-CG: 13·2% [95% CI 0·3, 24·4%] or 11·4% [95% CI 0·4, 21·2%] lower; ΔC-peptide(0-30)/Δglucose(0-30)) 19% [95% CI 3·1, 32·3%] or 17·7% [95% CI 2·6, 30·5%] lower). T+ patients had 17% higher HbA1c (95% CI 0·07, 0·28) and 7·7 mg/dL higher fasting plasma glucose levels (95% CI 0·2,15·3) than T- patients. We conclude that islet autoimmunity is much more prevalent in T2D patients than previously reported. T cell-mediated autoimmunity is associated with diminished β-cell function and worse glycemic control.