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著者: Satoshi Murao, Shiori Kondo, Jun Ohashi, Yasuhisa Fujii, Ikki Shimizu, Masao Fujiyama, Keizo Ohno, Yasuharu Takada, Kazuaki Nakai, Yukio Yamane, Haruhiko Osawa, Hideichi Makino
雑誌名: Diabetes Res Clin Pract. 2008 Apr;80(1):114-21. doi: 10.1016/j.diabres.2008.01.024. Epub 2008 Mar 14.
Abstract/Text
OBJECTIVE: To clarify the natural course and factors involved in beta cell failure in Japanese latent autoimmune diabetes in adults (LADA) patients.
RESEARCH DESIGN AND METHODS: Insulin secretion in 57 LADA patients identified from among 4980 adult-onset diabetic patients in a hospital-based Ehime study were examined over a 5-year period. Postprandial serum C-peptide levels below 0.33 nmol/l were defined as beta cell failure. The involvement of clinical and immunological factors in the progression to beta cell failure were evaluated.
RESULTS: Forty-two of the fifty-seven LADA patients completed the 5-year follow-up. Eleven (26.2%) required insulin treatment and five (11.9%) progressed to beta cell failure. A Cox regression analysis revealed that positive anti-thyroid peroxidase antibody (TPOAb) and insulinoma-associated protein 2 (IA-2Ab) were associated with the need for insulin treatment (p<0.05 and p<0.01, respectively). Positive TPOAb, anti-thyroglobulin antibody (TGAb), IA-2 antibody (p<0.01 for each), and lower serum fasting C-peptide levels (p<0.05) were contributors to the progression to beta cell failure. Involvement of type 1 diabetes susceptible HLA class II genes was not evident.
CONCLUSIONS: Japanese LADA patients are a heterogeneous population. In addition to IA-2 antibody, presence of TPOAb and fasting C-peptide level could indicate an oncoming deterioration of beta cell function.
PMID 18342387 Diabetes Res Clin Pract. 2008 Apr;80(1):114-21. doi: 10.1016/j.diabres.2008.01.024. Epub 2008 Mar 14.
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