Immunogenetic and Clinical Characterization of Slowly Progressive IDDM

摘要: OBJECTIVE To examine the clinical and immunogenetic heterogeneity of IDDM. RESEARCH DESIGN AND METHODS We divided 207 IDDM patients into groups based on interval from onset to initiation insulin therapy: group A ( n = 134), B (3–12 mo, intermediate group, 31), C (>13 slowly progressive 42). Immunogenetic markers were compared between C. RESULTS The mode age was higher in (52 yr) than (10 yr). Group had a prevalence islet cell antibodies (42.9%, 18 42) (25.4%, 34 134, P 0.05). Serum C-peptide immunoreactivity assayed by radioimmunoassay response 100-g oral glucose tolerance test significantly uhan A. also more likely have family history NIDDM (26.1%, 11 among their first-degree relatives (11.2%, 15 0.039). prevalences endocrine autoimmune diseases not different frequency complications disease (6.7%, 9 134) (2.3%, 1 Significant associations with two class I major histocompatibility complex antigens (HLA-A24 -Bw54) one II antigen (HLA-DR4) observed assocciated three diabetogenic HLA-DQ haplotypes including DQA1*0301-DQB1*0401, DQAl*0301-DQBl*0302, DQA1 *0301-DQB 1*0303. In contrast, lacked association antigens, although HLA-DR4 HLA-DQA1* 0301-DQB 1*0401 common this control subjects. CONCLUSIONS These results indicate that subtype course (slowly IDDM) has distinct findings late-age onset, high antibodies, preserved β-cell function, NIDDM. An additive effect is suggested as an explanation for acute manifestations severe destruction patients.