Anti-GAD Antibody in Patients with Adult-Onset Diabetes in Korea.

Sang Ah Lee; Eui Young Kim; Eun Hee Kim; Ji Yun Jeong; Eun Heui Jeong; Dong Woo Kim; Eun Hee Cho; Eun Hee Koh; Min Seon Kim; Joong Yeol Park; Ki Up Lee

doi:10.4093/kdj.2009.33.1.16

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Original Article Anti-GAD Antibody in Patients with Adult-Onset Diabetes in Korea.: Sang Ah Lee, Eui Young Kim, Eun Hee Kim, Ji Yun Jeong, Eun Heui Jeong, Dong Woo Kim, Eun Hee Cho, Eun Hee Koh, Min Seon Kim, Joong Yeol Park, Ki Up Lee; Diabetes & Metabolism Journal 2009;33(1):16-23
DOI: https://doi.org/10.4093/kdj.2009.33.1.16
Published online: February 1, 2009

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Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea. kulee@amc.seoul.kr

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Abstract

BACKGROUND
It is well known that the clinical characteristics of diabetes mellitus in Korean people are different from those of Western people. The purpose of this study was to investigate the prevalence of the anti-GAD antibody (GADA) in a large number of Korean patients with adult-onset diabetes. METHODS: The GADA was measured by radioimmunoassay for 11,472 adult-onset diabetic patients who visited the Asan Medical Center from 1998 to 2007. According to the fasting C-peptide levels, we classified the patients into an insulin dependent diabetes mellitus group (IDDM; C-peptide < 0.6 ng/mL) and non-insulin dependent diabetes mellitus group (NIDDM; C-peptide > or = 1.0 ng/mL). Other clinical and laboratory data were obtained from medical records. RESULTS: Among the 11,147 diabetic patients, 9,250 patients were classified as NIDDM, 922 patients were classified as IDDM and 975 patients excluded. Within the latter group 472 patients were to absolute insulin deficient (C-peptide < 0.1 ng/mL). The prevalence of GADA was 22.0% in the IDDM group and 4.7% in the NIDDM group. GADA was more prevalent in younger-onset NIDDM patients (25~40 years of age; 12.4%) than in older-onset NIDDM patients (> or = 40 years of age; 3.8%). The GADA-positive NIDDM patients had lower C-peptide and BMI levels, and higher rates of typical diabetic symptoms and insulin treatment. CONCLUSION: The prevalence of GADA in Korean patients with IDDM and NIDDM was lower than that reported in Western populations. It is thus suggested that autoimmunity is a rarer cause of diabetes in Korean people. However, since over 10% of younger-onset NIDDM patients were positive for GADA, routine GADA measurement in such patients is recommended.

Keywords: Diabetes mellitus;Glutamic acid decarboxylase;Korea;Prevalence;

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Anti-GAD Antibody in Patients with Adult-Onset Diabetes in Korea.

Korean Diabetes J. 2009;33(1):16-23. Published online February 1, 2009

DOI: https://doi.org/10.4093/kdj.2009.33.1.16

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