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Glutamic acid decarboxylase autoantibody prevalence and association with HLA genotype in patients with younger-onset type 1 diabetes and proliferative diabetic retinopathy.

Abstract：

OBJECTIVE:To investigate the relationship of HLA status and autoantibodies to glutamic acid decarboxylase (GAD) in proliferative diabetic retinopathy (PDR) to assess the role of autoimmunity and genetic markers in retinopathy. DESIGN:Retrospective, nonrandomized, comparative study. PARTICIPANTS:Patients who had suffered from type 1 diabetes for >10 years and who had been first diagnosed as diabetic under 30 years of age were studied. They were classified into 3 groups: 20 patients with diabetes and PDR (PDR group), 22 patients who had diabetes and severe nonproliferative diabetic retinopathy (SNPDR group), and 25 patients who had diabetes with no diabetic retinopathy (non-DR group). METHODS:Blood was collected, and the relationship between HLA status and GAD autoantibody positivity in diabetic retinopathy was investigated in a cross-sectional study. MAIN OUTCOME MEASURES:Human leukocyte antigen status and GAD autoantibody positivity. RESULTS:The highest positive rate of GAD autoantibody was 56.0% in the non-DR group, followed by the SNPDR group (40.1%) and the PDR group (15.0%). The frequencies of the HLA-DQ4 and -DR4/-DQ4 haplotypes were significantly higher in the PDR group (75.0% and 65%, respectively) than in the SNPDR group (40.9% and 31.8%) or the non-DR group (40.0% and 28.0%) (P = 0.035 and P = 0.026, respectively). The prevalence of GAD antibodies was lower in patients with the HLA-DR4 and HLA-DQ4 alleles and -DR4/-DQ4 haplotype frequencies in the PDR group (P = 0.018, P = 0.0088, and P = 0.0031, respectively). CONCLUSIONS:We found that the existence of GAD antibodies is inversely related and HLA status is directly related to the stage or severity of retinopathy.

journal_name

Ophthalmology

journal_title

Ophthalmology

authors

Mimura T,Funatsu H,Uchigata Y,Kitano S,Shimizu E,Amano S,Yamagami S,Noma H,Araie M,Hori S

doi

10.1016/j.ophtha.2005.05.016

subject

Has Abstract

pub_date

2005-11-01 00:00:00

pages

1904-9

issue

eissn

0161-6420

issn

1549-4713

pii

S0161-6420(05)00805-5

journal_volume

112

pub_type

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Glutamic acid decarboxylase autoantibody prevalence and association with HLA genotype in patients with younger-onset type 1 diabetes and proliferative diabetic retinopathy.