Presence of anti-GAD in a non-diabetic population of adults; time dynamics and clinical influence: results from the HUNT study
dc.contributor.author | Sørgjerd, Elin Pettersen | |
dc.contributor.author | Thorsby, Per Medbøe | |
dc.contributor.author | Torjesen, Peter A | |
dc.contributor.author | Skorpen, Frank | |
dc.contributor.author | Kvaløy, Kirsti | |
dc.contributor.author | Grill, Valdemar Erik Robert | |
dc.date.accessioned | 2015-07-09T12:41:22Z | |
dc.date.accessioned | 2015-07-15T07:05:02Z | |
dc.date.available | 2015-07-09T12:41:22Z | |
dc.date.available | 2015-07-15T07:05:02Z | |
dc.date.issued | 2015 | |
dc.identifier.citation | BMJ Open Diabetes Research & Care 2015, 3 | nb_NO |
dc.identifier.issn | 2052-4897 | |
dc.identifier.uri | http://hdl.handle.net/11250/293185 | |
dc.description | - Published article | nb_NO |
dc.description.abstract | Background 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.iso | eng | nb_NO |
dc.publisher | BMJ Publishing Group | nb_NO |
dc.rights | 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. | |
dc.rights.uri | http://creativecommons.org/licenses/by-nc/4.0/ | |
dc.title | Presence of anti-GAD in a non-diabetic population of adults; time dynamics and clinical influence: results from the HUNT study | nb_NO |
dc.type | Peer reviewed | en_GB |
dc.type | Journal article | nb_NO |
dc.date.updated | 2015-07-09T12:41:22Z | |
dc.source.volume | 3 | nb_NO |
dc.source.journal | BMJ Open Diabetes Research and Care | nb_NO |
dc.identifier.doi | 10.1136/bmjdrc-2014-000076 | |
dc.identifier.cristin | 1253040 | |
dc.description.localcode | CC BY-NC 4.0 | nb_NO |
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