Impact of Islet Autoimmunity on the Progressive β-Cell Functional Decline in Type 2 Diabetes
Impact of Islet Autoimmunity on the Progressive β-Cell Functional Decline in Type 2 Diabetes
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DOI：
10.2337/dc14-0961
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发表时间：
2014-12-01
期刊：
影响因子：
16.2
通讯作者：
Palmer, Jerry P.
中科院分区：
文献类型：
--
作者：
Brooks-Worrell, Barbara M.;Boyko, Edward J.;Palmer, Jerry P.
交叉研究表明，胰岛自身免疫在2型糖尿病（T2 D）中可能比以前认识到的更普遍，并可能导致β细胞功能的进行性下降。在这项研究中，我们纵向评估了胰岛自身免疫发展对T2Dpatients.RESEARCH设计和METHODSTwent-three胰岛自身抗体（GAD抗体和胰岛素瘤相关蛋白2）和胰岛特异性T细胞阴性的T2 D患者进行了长达36个月的前瞻性评估。我们调查了胰岛自身抗体（Ab+）和/或胰岛反应性T细胞（T+）患者的百分比，以及胰岛自身免疫对空腹和胰高血糖素刺激的C肽反应的影响。在23名患者中，6名（26%）胰岛自身免疫（Ab T）保持阴性，14名（61%）发展为Ab+和/或T+，3名（13%）无法分类，因为他们只在一次研究访视时发展为胰岛自身免疫。观察到胰岛Ab+的稳定性低于胰岛特异性T细胞应答。胰岛自身免疫的发展与空腹（P < 0.0001）和胰高血糖素刺激（P < 0.05）C肽反应的更快下降显著相关。CONCLUSIONSSThese pilot data suggest that the development of islet autoimmune in T2 D is associated with a significant more rapid beta-cell functional decline.
OBJECTIVECross-sectional studies have suggested that islet autoimmunity may be more prevalent in type 2 diabetes (T2D) than previously appreciated and may contribute to the progressive decline in beta-cell function. In this study, we longitudinally evaluated the effect of islet autoimmune development on the progressive beta-cell dysfunction in T2D patients.RESEARCH DESIGN AND METHODSTwenty-three T2D patients negative for islet autoantibodies (GAD antibody and insulinoma-associated protein 2) and islet-specific T cells were evaluated prospectively for up to 36 months. We investigated the percentage of patients who developed islet autoantibodies (Ab+) and/or islet-reactive T cells (T+) and the effect of the islet autoimmunity on fasting and glucagon-stimulated C-peptide responses. We defined positive islet autoimmunity as Ab+ and/or T+ for at least two study visits.RESULTSOf the 23 patients, 6(26%) remained negative for islet autoimmunity (Ab T), 14 (61%) developed Ab+ and/or T+, and 3 (13%) were unclassifiable because they developed islet autoimmunity at only one study visit. Islet Ab+ was observed to be less stable than islet-specific T-cell responses. Development of islet autoimmunity was significantly associated with a more rapid decline in fasting (P < 0.0001) and glucagon-stimulated (P < 0.05) C-peptide responses.CONCLUSIONSThese pilot data suggest that the development of islet autoimmunity in T2D is associated with a significantly more rapid beta-cell functional decline.