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HLA-DQB1 genotypes, islet antibodies and beta cell function in the classification of recent-onset diabetes among young adults in the nationwide Diabetes Incidence Study in Sweden
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2006 (English)In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 49, no 8, 1785-1794 p.Article in journal (Refereed) Published
Abstract [en]

AIMS/HYPOTHESIS: The World Health Organization considers an aetiological classification of diabetes to be essential. The aim of this study was to evaluate whether HLA-DQB1 genotypes facilitate the classification of diabetes as compared with assessment of islet antibodies by investigating young adult diabetic patients.

SUBJECTS AND METHODS: Blood samples were available at diagnosis for 1,872 (90%) of the 2,077 young adult patients (aged 15-34 years old) over a 5-year period in the nationwide Diabetes Incidence Study in Sweden. Islet antibodies were measured at diagnosis in 1,869 patients, fasting plasma C-peptide (fpC-peptide) after diagnosis in 1,522, while HLA-DQB1 genotypes were determined in 1,743.

RESULTS: Islet antibodies were found in 83% of patients clinically considered to have type 1 diabetes, 23% with type 2 diabetes and 45% with unclassifiable diabetes. After diagnosis, median fpC-peptide concentrations were markedly lower in patients with islet antibodies than in those without (0.24 vs 0.69 nmol/l, p<0.0001). Irrespective of clinical classification, patients with islet antibodies showed increased frequencies of at least one of the risk-associated HLA-DQB1 genotypes compared with patients without. Antibody-negative patients with risk-associated HLA-DQB1 genotypes had significantly lower median fpC-peptide concentrations than those without risk-associated genotypes (0.51 vs 0.74 nmol/l, p=0.0003).

CONCLUSIONS/INTERPRETATION: Assessment of islet antibodies is necessary for the aetiological classification of diabetic patients. HLA-DQB1 genotyping does not improve the classification in patients with islet antibodies. However, in patients without islet antibodies, HLA-DQB1 genotyping together with C-peptide measurement may be of value in differentiating between idiopathic type 1 diabetes and type 2 diabetes.

Place, publisher, year, edition, pages
2006. Vol. 49, no 8, 1785-1794 p.
Keyword [en]
HLA-DQB1 genotypes; classification; C-peptide; islet antibodies
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:uu:diva-211274DOI: 10.1007/s00125-006-0293-5ISI: 000238859900011PubMedID: 16783473OAI: oai:DiVA.org:uu-211274DiVA: diva2:681616
Available from: 2013-12-20 Created: 2013-11-21 Last updated: 2017-12-06Bibliographically approved

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Eriksson, Jan W.

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