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Glutamic acid decarboxylase and islet antigen 2 antibody profiles in people with adult‐onset diabetes mellitus: a comparison between mixed ethnic populations in Singapore and Germany
Author(s) -
Ong Y. H.,
Koh W. C. A.,
Ng M. L.,
Tam Z. Y.,
Lim S. C.,
Boehm B. O.
Publication year - 2017
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.13358
Subject(s) - medicine , cohort , glutamate decarboxylase , population , diabetes mellitus , autoantibody , antibody , islet , gastroenterology , immunology , endocrinology , insulin , biology , biochemistry , enzyme , environmental health
Aim To gain insight into the presence of islet cell autoimmunity in an ethnic Asian compared with a white European population. Methods For this cross‐sectional study we recruited people with adult‐onset diabetes (age of diagnosis 20–60 years), at tertiary referral centres in Germany ( n =1020) and Singapore ( n =1088). Glutamic acid decarboxylase and islet antigen 2 antibodies were measured according to Islet Autoantibody Standardization Program protocols. Results The prevalence of glutamic acid decarboxylase antibody positivity was 13.9% (95% CI 12.1–16.0; P <0.001) in the white European cohort compared with 6.8% (95% CI 5.5–8.4; P <0.001) in the Asian cohort. Glutamic acid decarboxylase antibody positivity was 11.4% (95% CI 7.7–16.6) in Indian, 6.0% (95% CI 3.6–9.9) in Malay and 5.8% (95% CI 4.3–7.7; P <0.001) in Chinese participants. In the white European participants, the prevalence of islet antigen 2 antibody positivity was 7.8% (95% CI 6.4–9.4) compared with 14.8% (95% CI 12.8–17.0; P <0.001) in the Asian cohort as a whole, and among the three ethnicities in the Asian cohort it was 12.4% (95% CI 8.6–17.7) in Indian, 16.8% (95% CI 12.6–22.2) in Malay and 15.7% (95% CI 13.2–18.6) in Chinese participants. Double antibody positivity was seen in 5.7% (95% CI 4.5–7.1) of white European participants compared with 1.6% (95% CI 1.0–2.5; P <0.01) of Asian participants. In the white European cohort, those who were glutamic acid decarboxylase autoantibody‐positive had a lower BMI than those who were autoantibody‐negative, but this trend was absent in the Asian cohort. Conclusions A marked prevalence of islet cell autoimmunity was observed in people with adult‐onset diabetes. While glutamic acid decarboxylase antibodies were more frequent in the European cohort, islet antigen 2 antibody positivity was highest in the three ethnic groups in Singapore, suggesting ethnic‐specific differences in antibody profiles.