Clinical characteristics of anti-glutamic acid decarboxylase antibody-positive fulminant type 1 diabetes
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- Saito Daigo
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
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- Oikawa Yoichi
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
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- Mizutani Gen
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
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- Inoue Kazuyuki
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
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- Hatano Masako
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
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- Inoue Ikuo
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
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- Noda Mitsuhiko
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
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- Shimada Akira
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
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抄録
<p>This research aimed to examine the relationship between anti-glutamic acid decarboxylase antibody (GADA) titers and clinical parameters at onset and to clarify the association between clinical severity and GADA titers in GADA-positive fulminant type 1 diabetes. This cross-sectional observational study included 20 cases with GADA-positive fulminant type 1 diabetes (4 cases from our hospital and 16 from cases reported in the literature). The association between GADA titers and clinical parameters [age, sex, body weight, body mass index, period from appearance of any prodromal symptoms to diagnosis, period from development of hyperglycemic symptoms to diagnosis, GADA titer, HbA1c level, blood pH and HCO3– level, serum levels of ketone bodies and pancreatic exocrine enzymes] were analyzed. Spearman’s rank correlation coefficient (rs) was used for the correlation analysis. The results showed that there was a significant inverse correlation between GADA titers and the “period from appearance of any prodromal symptoms to diagnosis” (rs = –0.559, p < 0.05). Moreover, GADA titers were inversely correlated with blood pH and HCO3– level (rs = –0.576, p < 0.05, rs = –0.578, p < 0.05, respectively), and positively correlated with serum levels of total ketone bodies, acetoacetate, and 3-hydroxybutyrate (rs = 0.661, p < 0.05; rs = 0.700, p < 0.05; and rs = 0.782, p < 0.01, respectively). These findings suggest that higher GADA titers may be linked to more severe clinical severity of GADA-positive fulminant type 1 diabetes at onset. This association may be attributed to possible pre-existence of autoimmunity-related β-cell damage before the onset of fulminant type 1 diabetes.</p>
収録刊行物
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- Endocrine Journal
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Endocrine Journal 66 (4), 329-336, 2019
一般社団法人 日本内分泌学会