EPIDEMIOLOGY OF ISLET CELL AUTOIMMUNITY IN NIDDM

NIDDM 胰岛细胞自身免疫的流行病学

• 批准号: 6285703
• 负责人: MASSIMO T PIETROPAOLO
• 金额: $ 30.15万
• 依托单位: CHILDREN'S HOSP PITTSBURGH/UPMC HLTH SYS
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-04-01 至 2004-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6285703
• 关键词: African American; age difference; autoantibody; autoimmunity; biomarker; caucasian American; epidemiology; female; gender difference; glucose tolerance; glutamate decarboxylase; human old age (65+); human subject; inflammation; longitudinal human study; male; noninsulin dependent diabetes mellitus; pancreatic islets; patient oriented research; racial /ethnic difference

DESCRIPTION: Several lines of evidence indicate that Type 2 (non-insulin-dependent) diabetes mellitus is a heterogeneous disease that results from a combination of abnormalities in both insulin secretion and insulin action. The causes of decreased insulin secretion in Type 2 diabetes are still not completely understood, but in a subgroup of Type 2 diabetic patients they may be related to an autoimmune destruction of the pancreatic beta cells. A pronounced activation of the acute-phase response, that was found to be associated with islet cell autoimmunity in the Preliminary Studies, may in part explain the defect in insulin secretion seen in Type 2 diabetes. There have been no extensive investigations, particularly in the U.S., with regard to the prevalence and clinical significance of islet cell autoimmunity particularly in elderly patients with Type 2 diabetes. Two of the most widely used markers for the diagnosis and prediction of autoimmune diabetes, namely GAD65 and IA-2 autoantibodies, along with inflammatory markers of activation of the acute phase response, will be applied in a well-characterized population of Type 2 diabetic patients over the age of 65 from the Cardiovascular Health Study (CHS). The CHS is a longitudinal study, which was proposed to identify and evaluate factors, such as diabetes mellitus, related to the incidence and the natural history of Coronary Heart Disease (CHD) and stroke in non-institutionalized adults 65 years and older. The identification of individuals at risk of developing autoimmune Type 2 diabetes is of public health interest because immunomodulatory strategies could potentially be instituted early enough to prevent the complications related with hyperglycemia and, possibly, the time of onset of insulin requirement. A more appropriate characterization of a subgroup of Type 2 diabetic patients of autoimmune pathogenesis will be of benefit to future research into the etiology, natural history as well as treatment of Type 2 diabetes mellitus.

描述：几行证据表明该类型2 （非胰岛素依赖性）糖尿病是一种异质疾病， 胰岛素分泌和 胰岛素作用。 2型糖尿病中胰岛素分泌减少的原因 仍然不完全了解，而是在2型糖尿病的子组中 他们可能与胰腺自身免疫性破坏有关 β细胞。急性相反应的明显激活，发现 在初步研究中与胰岛细胞自身免疫有关，可能 部分解释了2型糖尿病中胰岛素分泌的缺陷。那里 没有经过广泛的调查，特别是在美国 胰岛细胞自身免疫的患病率和临床意义 特别是在2型糖尿病的老年患者中。最广泛的两个 用于诊断和预测自身免疫性糖尿病的标记物，即 GAD65和IA-2自身抗体，以及激活的炎症标记 急性相响应将应用于良好的人群 2型糖尿病患者在65岁以上的心血管健康 研究（CHS）。 CHS是一项纵向研究，提议识别 并评估与发病率有关的因素，例如糖尿病 冠心病（CHD）和中风的自然历史 非机构化的成年人65岁及以上。识别 患有自身免疫性2型糖尿病的人是公开的 健康兴趣是因为免疫调节策略可能是 提早起初以防止与高血糖相关的并发症 并且可能是胰岛素需求的发作时间。更合适的 自身免疫2型糖尿病患者的亚组的表征 发病机理将有益于对病因的未来研究，自然 历史以及2型糖尿病的治疗。