Posted by Dennis on May 31, 2002 at 13:46:08:
In Reply to: no antibodies? posted by mike on May 29, 2002 at 13:39:11:
Relation between Course of Disease in Type 1 Diabetes and Islet Cell Antibodies
M. ZAMAKLAR, A. JOTIC, N. LALIC, K. LALIC, N. RAJKOVIC and T. MILICIC
Institute for Endocrinology, Diabetes and Metabolic Disease, Clinical Center of Serbia, School of Medicine, Belgrade University, 11000 Belgrade, Yugoslavia
The aim of this study was to estimate the possibility of predicting the course of type 1 diabetes. We analyzed the importance of islet cell antibody levels and residual ß cell function in 46 newly diagnosed patients with diabetes. Islet cell antibodies (ICAs; Juvenile Diabetes Foundation [JDF] units) were determined at the time of diagnosis by the indirect immunofluorescent method. ß cell function was estimated by C peptide levels (nmol/L) before and after glucagon stimulation at the time of clinical remission. Of the 46 patients, 13 were ICA negative (group A). Among ICA-positive patients, ICAs were < 20 JDF units (group B) in 15, between 20 and 80 JDF in 9 (group C), and > 80 JDF in 9 (group D). In group A, 9 patients had clinical remission for 7.5 ± 1.7 months. Their basal C peptide level was 0.26 ± 0.05 nmol/L and it increased after stimulation to 44.5 ± 2.5%. Ten patients in group B had remission for 6.2 ± 1.5 months. Their basal C peptide levels (0.28 ± 0.07 nmol/L) were similarly increased after stimulation (47.5 ± 2.5%). In group C, all patients had remission and it was of the longest duration (14.7 ± 1.5 months). They had the highest basal C peptide levels (0.45 ± 0.12 nmol/L) with increases to 57.5 ± 3.5%. Seven patients in group D with ICA levels > 80 JDF had a short remission (3.2 ± 1.2 months) despite good basal C peptide levels (0.42 ± 0.05 nmol/L) and excellent increases after stimulation (92.5%).
Our results suggest that moderate levels of ICA are associated with good residual ß cell function and longer remission.
Very high ICA levels (> 80 JDF) at the time of diagnosis despite better ß cell function are associated with short clinical remission.
Therefore, high ICA levels could be a marker of strong autoimmune reaction and accelerated depletion of ß cell function.