EPIDEMIOLOGY OF ISLET CELL AUTOIMMUNITY IN NIDDM

NIDDM 胰岛细胞自身免疫的流行病学

• 批准号: 6635180
• 负责人: MASSIMO T PIETROPAOLO
• 金额: $ 29.78万
• 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 2005-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6635180
• 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：几条证据表明，2型糖尿病 （非胰岛素依赖型）糖尿病是一种异质性疾病， 是由于胰岛素分泌和胰岛素分泌的异常， 胰岛素作用。2型糖尿病胰岛素分泌减少的原因 仍然没有完全理解，但在2型糖尿病患者的亚组中， 患者，它们可能与胰腺的自身免疫性破坏有关。 β细胞急性期反应的明显激活， 与胰岛细胞自身免疫相关，可能 部分解释了2型糖尿病中胰岛素分泌的缺陷。那里 还没有广泛的调查，特别是在美国，关于 胰岛细胞自身免疫发生率及其临床意义 特别是在患有2型糖尿病的老年患者中。两个最广泛的 使用标记物来诊断和预测自身免疫性糖尿病，即 GAD 65和IA-2自身抗体，沿着炎症标志物， 急性期反应，将适用于一个良好的特点人口， 65岁以上2型糖尿病患者从心血管健康 研究（CHS）。CHS是一项纵向研究，旨在确定 并评估与发病率相关的因素，如糖尿病， 冠心病和中风的自然史 65岁及以上的非机构化成年人。的识别 2型糖尿病的发病率是多少？ 健康利益，因为免疫调节策略可能 及早预防高血糖相关并发症 以及可能的胰岛素需求开始的时间。更合适的 自身免疫性2型糖尿病患者亚组的特征 发病机制将有利于今后的病因学研究，自然 2型糖尿病的治疗