The heterogeneity of islet autoantibodies and the progression of islet failure in type 1 diabetic patients

• Published in: Science China. Life sciences Vol. 59; no. 9; pp. 930 - 939
• Main Authors: Liu, Jin, Bian, Lingling, Ji, Li, Chen, Yang, Chen, Heng, Gu, Yong, Ma, Bingqin, Gu, Wei, Xu, Xinyu, Shi, Yun, Wang, Jian, Zhu, Dalong, Sun, Zilin, Ma, Jianhua, Jin, Hui, Shi, Xing, Miao, Heng, Xin, Bing, Zhu, Yan, Zhang, Zhenwen, Bu, Ruifang, Xu, Lan, Shi, Guangde, Tang, Wei, Li, Wei, Zhou, Dongmei, Liang, Jun, Cheng, Xingbo, Shi, Bimin, Dong, Jixiang, Hu, Ji, Fang, Chen, Zhong, Shao, Yu, Weinan, Lu, Weiping, Wu, Chenguang, Qian, Li, Yu, Jiancheng, Gao, Jialin, Fei, Xiaoqiang, Zhang, Qingqing, Wang, Xueqin, Cui, Shiwei, Cheng, Jinluo, Xu, Ning, Wang, Guofeng, Han, Guoqing, Xu, Chunrong, Xie, Yun, An, Minmin, Zhang, Wei, Wang, Zhixiao, Cai, Yun, Fu, Qi, Fu, Yu, Zheng, Shuai, Yang, Fan, Hu, Qingfang, Dai, Hao, Jin, Yu, Zhang, Zheng, Xu, Kuanfeng, Li, Yifan, Shen, Jie, Zhou, Hongwen, He, Wei, Zheng, Xuqin, Han, Xiao, Yu, Liping, She, Jinxiong, Zhang, Mei, Yang, Tao
• Format: Journal Article
• Language: English
• Published: Beijing Science China Press 01-09-2016; Springer Nature B.V
• Subjects: Adolescent; Adult; Asian Continental Ancestry Group; Autoantibodies - blood; Autoantibodies - immunology; Biomedical and Life Sciences; Body Mass Index; C-Peptide - blood; Cation Transport Proteins - immunology; China; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - ethnology; Diabetes Mellitus, Type 1 - immunology; Disease Progression; Enzyme-Linked Immunosorbent Assay; Female; Glutamate Decarboxylase - immunology; Humans; Insulin - immunology; Islets of Langerhans - immunology; Life Sciences; Logistic Models; Logistic回归; Male; Middle Aged; Radioimmunoassay; Receptor-Like Protein Tyrosine Phosphatases, Class 8 - immunology; Research Paper; Risk Factors; Young Adult; Zinc Transporter 8; 异质性; 患者; 糖化血红蛋白; 糖尿病; 胰岛; 自身抗体; 衰竭; type 1 diabetes; autoantibodies; heterogeneity; islet failure
• ISSN: 1674-7305; 1869-1889
• DOI: 10.1007/s11427-016-5052-3

Type 1 diabetes mellitus is heterogeneous in many facets. The patients suffered from type 1 diabetes present several levels of islet function as well as variable number and type of islet-specific autoantibodies. This study was to investigate prevalence and heterogeneity of the islet autoantibodies and clinical phenotypes of type 1 diabetes mellitus; and also discussed the process of islet failure and its risk factors in Chinese type 1 diabetic patients. A total of 1,291 type 1 diabetic patients were enrolled in this study. Demographic information was collected. Laboratory tests including mixed-meal tolerance test, human leukocyte antigen alleles, hemoglobin A1 c, lipids, thyroid function and islet autoantibodies were conducted. The frequency of islet-specific autoantibody in newly diagnosed T1 DM patients（duration shorter than half year） was 73% in East China. According to binary logistic regressions, autoantibody positivity, longer duration and lower Body Mass Index were the risk factors of islet failure. As the disease developed, autoantibodies against glutamic acid decarboxylase declined as well as the other two autoantibodies against zinc transporter 8 and islet antigen 2. The decrease of autoantibodies was positively correlated with aggressive beta cell destruction. Autoantibodies can facilitate the identification of classic T1 DM from other subtypes and predict the progression of islet failure. As there were obvious heterogeneity in autoantibodies and clinical manifestation in different phenotypes of the disease, we should take more factors into consideration when identifying type 1 diabetes mellitus.