Antibodies to Glutamic Acid Decarboxylase-65 is Associated with Total Daily Dose of Insulin Requirement in Children with Type 1 Diabetes

F. Faisal, N. Rochmah, M. Faizi, Novina Novina, Erni Nuraeni
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Abstract

BACKGROUND: Type 1 diabetes (T1D) mostly occurs due to the destruction of pancreatic beta cells due to autoimmune processes. Diagnosis of T1D can be established by examining the c-peptide levels and the markers of pancreatic autoantibodies, including glutamic acid decarboxylase 65 autoantibodies (GAD-65). However, the association between c-peptide and anti-GAD-65 toward patients’ clinical manifestations needs to be further explored. Hence, the aim of current study was to identify the association of anti-GAD65 with c-peptide and clinical characteristics in children with T1D.METHODS: Case-control study involving 47 T1D children (T1D group) and 41 healthy children (control group) younger than 18 years old was conducted. Secondary data regarding subjects’ demographic characteristics and medical history were collected from subjects, and serum blood was drawn from each subject for the anti-GAD65 and c-peptide measurement. Anti-GAD65 and c-peptide levels were measured using an Enzyme-Linked Immunosorbent Assay (ELISA) methods.RESULTS: Anti-GAD65 antibody was detected in 78.7% T1D group, while only 2.43% were detected in control group subject (p=0.0000). The c-peptide level of T1D group was 0.07±0.19 nmol/L and control group was 1.5±0.77 nmol/L (p=0.0000). The total daily dose of insulin in subjects with positive anti-GAD65 was greater than in the negative anti-GAD65 (p=0.012). The sensitivity and specificity of the anti-GAD65 were 85.4% was 66.7%, respectively.CONCLUSION: The results of this study show that anti-GAD65 was associated with total daily dose of insulin requirement in children with T1D.KEYWORDS: diabetes mellitus, type 1 diabetes, anti-GAD65, c-peptide
谷氨酸脱羧酶-65抗体与1型糖尿病儿童每日总胰岛素需用量相关
背景:1型糖尿病(T1D)的发生主要是由于自身免疫过程对胰腺β细胞的破坏。T1D的诊断可以通过检测c肽水平和胰腺自身抗体标志物,包括谷氨酸脱羧酶65自身抗体(GAD-65)来确定。但c肽与抗gad -65对患者临床表现的相关性有待进一步探讨。因此,本研究的目的是确定抗gad65与c肽和T1D儿童临床特征的关系。方法:选取47例T1D患儿(T1D组)和41例18岁以下健康儿童(对照组)进行病例对照研究。收集受试者的人口统计学特征和病史等次要资料,并抽取每位受试者的血清进行抗gad65和c肽检测。采用酶联免疫吸附法(ELISA)检测抗gad65和c肽水平。结果:T1D组患者血清中检测到抗gad65抗体的比例为78.7%,对照组仅为2.43% (p=0.0000)。T1D组c肽水平为0.07±0.19 nmol/L,对照组为1.5±0.77 nmol/L (p=0.0000)。抗gad65阳性受试者的胰岛素日总剂量大于抗gad65阴性受试者(p=0.012)。抗gad65的敏感性和特异性分别为85.4%和66.7%。结论:本研究结果表明,抗gad65与T1D儿童每日胰岛素总需用量有关。关键词:糖尿病,1型糖尿病,抗gad65, c肽
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