The role of anti-islet cell autoantibodies (GADA & IA-2A) in type 2 Diabetes Mellitus.

Abstract

A case-control study has been conducted to determine the prevalence of islet cell autoantibodies, (Glutamic acid decarboxylase autoantibodies"GADA" & Tyrosin phosphatase –like protein autoantibodies "IA-2A")in type 2 diabetic patients .During the period from November /2007 through the end of June /2008, the study enrolled 64diabetic patients who attended AL-Hakeem Centre for Researches and Treatment of DM in AL-Sader Teaching Hospital in Al-Najef city –Iraq.Fasting blood sugar test was done for every patient , fasting insulin concentration & serological tests for GADA ( by using Enzyme –linked immunosorbent assay "ELISA" )& IA-2A by ( Immuno radiometric assay"IRMA") have been done for all sera of the study groups .it is noticed that (15, 23.4%) and (10,15.6%) of those patients were positive for GADA and IA-2Arespectively and those patients(Latent autoimmune diabetes of adult "LADA" patients) characterized by certain clinical features that differentiate them from islet cell autoantibodies negatives type 2 diabetics as it was found that the majority of patients with islet cell positivity develop the disease at younger age than those negative patients (30.95% Vs 9.1%) regarding GADA & (21.42% Vs 4.5%) regarding IA-2A Also it was found that type 2 diabetic patients with islet cell autoantibody tend to be none obese & had lower body mass index "BMI" than those with negative islet cell autoantibodies. Statistical analysis showed high significant correlation between BMI & islet cell autoantibody positivity (P <0.001). When fasting insulin concentration was measured in islet cell autoantibodies positive type 2 diabetic patients, the majority of them(80.95%) had low fasting insulin level & no one of them exhibit hyperinsulinemia in contrast to type 2 diabetic patients where hyperinsulinmia is the predominant feature.