Korean Diabetes J.  2009 Feb;33(1):16-23. 10.4093/kdj.2009.33.1.16.

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

• Lee SA
• Kim EY
• Kim EH
• Jeong JY
• Jeong EH
• Kim DW
• Cho EH
• Koh EH
• Kim MS
• Park JY
• Lee KU

• KMID: 2222479
• DOI: http://doi.org/10.4093/kdj.2009.33.1.16

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.

Keyword

Diabetes mellitus; Glutamic acid decarboxylase; Korea; Prevalence

MeSH Terms

Autoimmunity
C-Peptide
Diabetes Mellitus
Diabetes Mellitus, Type 1
Diabetes Mellitus, Type 2
Fasting
Glutamate Decarboxylase
Humans
Insulin
Korea
Medical Records
Prevalence
Radioimmunoassay
C-Peptide
Glutamate Decarboxylase
Insulin

Figure

• 

  Fig. 1 Anti-GAD antibody titer in diabetic patients according to the onset-age. Among NIDDM patients, those who were diagnosed before 40 years of age had higher titer of Anti-GAD antibody than those diagnosed after 40 years of age. *P < 0.05. GAD, glutamic acid decarboxylase; IDDM, insulin dependent diabetes mellitus; NIDDM, non-insulin dependent diabetes mellitus.

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