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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Islet autoantibody positivity in overweight and obese adults with type 2 diabetes
Autoimmunity (Chur, Switzerland), v 51(8), pp 408-416
01 Dec 2018
PMID: 30661481
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Islet autoantibodies are typically associated with type 1 diabetes, but have been found in patients diagnosed with type 2 diabetes in whom they are associated with lower adiposity. The significance of autoantibody positivity in overweight and obese patients is not well understood. The aim of this study was to determine the prevalence and clinical significance of islet autoantibodies in overweight/obese adults diagnosed with type 2 diabetes. This study includes 204 participants at one site of the multicenter Look AHEAD (Action for Health in Diabetes) trial (ClinicalTrials.gov identifier: NCT00017953) which randomized overweight/obese adults diagnosed with type 2 diabetes to an intensive lifestyle intervention or diabetes support and education. We measured antibodies to glutamic acid decarboxylase, insulinoma antigen-2, and zinc transporter 8. Participants with and without autoantibodies were compared with respect to baseline clinical features, and longitudinal changes in weight, hemoglobin A1c, and antihyperglycemic medications. We found that 13 participants (6.4%) were autoantibody positive, including six of 47 participants (12.8%) with BMI ≥40 kg/m
2
. At baseline, autoantibody positive participants had higher HDL cholesterol (1.27 vs. 1.09 mmol/L, p = .034) and lower fasting C-peptide (0.32 vs. 0.57 nmol/L, p = .049). Over four years, autoantibody positive participants lost 5.1 kg more weight than autoantibody negative participants (p = .056). Longitudinal changes in hemoglobin A1c did not differ by autoantibody status, though autoantibody positive participants were more likely to increase the number of antihyperglycemic medications or initiate insulin (p = .011). In conclusion, islet autoantibodies were present in 6.4% of overweight/obese adults with type 2 diabetes including those with severe obesity, and were associated with distinct clinical features. The effect of autoantibody positivity on weight loss interventions requires further study.
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- Title
- Islet autoantibody positivity in overweight and obese adults with type 2 diabetes
- Creators
- Scott J. Pilla - Johns Hopkins MedicineAshok Balasubramanyam - Baylor College of MedicineWilliam C. Knowler - National Institute of Diabetes and Digestive and Kidney DiseasesMariana Lazo - Johns Hopkins MedicineDavid M. Nathan - Massachusetts General HospitalXavier Pi-Sunyer - Columbia University Irving Medical CenterJeanne M. Clark - Johns Hopkins UniversityNisa M. Maruthur - Johns Hopkins MedicineLook AHEAD Res Grp
- Publication Details
- Autoimmunity (Chur, Switzerland), v 51(8), pp 408-416
- Publisher
- Taylor & Francis
- Grant note
- 5T32HL007180-40 / National Institute of Diabetes and Digestive and Kidney Diseases U01DK057178-18 / NIH/NIDDK National Heart, Lung, and Blood Institute U01DK057177-18 / NIH/NIDDK U01DK057154-18 / NIH/NIDDK U01DK057149-17 / NIH/NIDDK
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative
- Web of Science ID
- WOS:000456297700005
- Scopus ID
- 2-s2.0-85059543168
- Other Identifier
- 991020550497904721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Immunology