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dc.contributor.authorSørgjerd, Elin Pettersen
dc.contributor.authorThorsby, Per Medbøe
dc.contributor.authorTorjesen, Peter A
dc.contributor.authorSkorpen, Frank
dc.contributor.authorKvaløy, Kirsti
dc.contributor.authorGrill, Valdemar Erik Robert
dc.date.accessioned2015-07-09T12:41:22Z
dc.date.accessioned2015-07-15T07:05:02Z
dc.date.available2015-07-09T12:41:22Z
dc.date.available2015-07-15T07:05:02Z
dc.date.issued2015
dc.identifier.citationBMJ Open Diabetes Research & Care 2015, 3nb_NO
dc.identifier.issn2052-4897
dc.identifier.urihttp://hdl.handle.net/11250/293185
dc.description- Published articlenb_NO
dc.description.abstractBackground It is well known that anti-GAD (glutamic acid decarboxylase) serves as a marker for development of autoimmune diabetes in adults. On the other hand, the clinical implications of anti-GAD positivity in persistently non-diabetic (PND) adults are poorly elucidated. Our aim was to establish the frequency of anti-GAD in PNDs in an all-population-based cohort from the Nord-Trøndelag health study (HUNT) and to prospectively test for associations with glucose tolerance and thyroid autoimmunity. Methods We formed a primary study population (4496 individuals), selected randomly from the age group 20–90 years (50% men/women), who were non-diabetic both at HUNT2 (1995–1997) and HUNT3 (2006–2008). Anti-GAD-positive individuals at HUNT2, together with anti-GAD-negative individuals aged 20–29 years, were retested for anti-GAD positivity at HUNT3. A secondary study population consisted of individuals with type 2 diabetes (T2D, n=349) at HUNT3 who developed diabetes between HUNT2 and HUNT3. Results The frequency of anti-GAD positivity in PND was 1.7% (n=76) at HUNT2. Positivity did not associate with gender, family history of diabetes, or glucose levels, but was associated with thyroid-associated autoimmunity (increased frequency of positivity for anti-TPO (thyroid peroxidase), p<0.002). HLA-DQA1/DQB1, a risk haplotype for autoimmunity, was also associated with anti-GAD positivity in PND. The incidence of anti-GAD positivity was low (0.4%) in the subsample of individuals who were anti-GAD negative in HUNT2. Anti-GAD positivity in PNDs was frequently evanescent, with 54% losing, usually low-grade, positivity between HUNT2 and HUNT3. An evanescent state of autoimmunity as assessed by anti-GAD positivity during “pre-diabetes” in individuals later diagnosed with T2D could, however, not be affirmed. Conclusions Anti-GAD positivity in PND is associated with HLA risk haplotypes and thyroid autoimmunity but not with clinical parameters of diabetes. Fleeting anti-GAD positivity is common; however, results do not support the notion of a history of autoimmunity in T2D in the present cohort.nb_NO
dc.language.isoengnb_NO
dc.publisherBMJ Publishing Groupnb_NO
dc.rightsThis is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.titlePresence of anti-GAD in a non-diabetic population of adults; time dynamics and clinical influence: results from the HUNT studynb_NO
dc.typePeer revieweden_GB
dc.typeJournal articlenb_NO
dc.date.updated2015-07-09T12:41:22Z
dc.source.volume3nb_NO
dc.source.journalBMJ Open Diabetes Research and Carenb_NO
dc.identifier.doi10.1136/bmjdrc-2014-000076
dc.identifier.cristin1253040
dc.description.localcodeCC BY-NC 4.0nb_NO


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This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
Med mindre annet er angitt, så er denne innførselen lisensiert som This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.