Biomedical subjects

Gan Huang

Publications and source records attributed to Gan Huang.

At least 19 recordsLinked to original sources

PubMed2006

The CD4(+) regulatory T-cells is decreased in adults with latent autoimmune diabetes.

The latent autoimmune diabetes in adults (LADA) is a subgroup of type 1 diabetes, which procession of autoimmune destruction of beta-cells was slower than classic type 1 diabetes. To investigate the pathogenesis of LADA, we examined the lymphocyte subsets including the CD4(+)CD25(+) T-cells in 60 LADA patients and 30 patients of type 2 diabetes and 30 healthy individuals by FACS. And we compared the expression of FOXP3 mRNA in CD4(+) T-cell between 10 patients of LADA and 10 matched healthy individuals by real time PCR. The percent of CD4(+)CD25(+) T-cells were higher (11.89+/-4.96% versus 8.16+/-3.65%, P<0.01), and the percent CD8(+) T-cells elevated (24.58+/-6.80% versus 19.39+/-7.12, P<0.01) in LADA patients than healthy individuals. While the expression of FOXP3 mRNA in CD4(+) T-cell was markedly decreased in LADA patients (0.52-fold, n=10, P=0.004) compared with normal subjects. In addition, the percent of CD8(+) T-cells related with GAD-Ab titers in LADA patients (r=0.292, P=0.03). Our results showed that there were cellular immune disorder and decreased CD4(+) regulatory T-cells in LADA patients. The adoptive transfer regulatory T-cells seem to be a potential therapeutics for LADA.

Adult↗

PubMed2006

[Decrease of FOXP3 mRNA in CD4+ T cells in latent autoimmune diabetes in adult].

OBJECTIVE: To study the percentage of peripheral blood CD4(+)CD25(+) T cells and the expression of FOXP3 mRNA in the patients with latent autoimmune diabetes in adult (LADA). METHODS: Fresh peripheral blood samples were obtained from 60 patients with LADA, 30 patients with type 2 diabetes and 30 age- and sex-matched matched healthy nondiabetic control subjects without diabetic family history. Two-color staining (anti-CD4, anti-CD25, anti-CD3, and anti-CD8) flow cytometric analysis was employed to measure the CD4(+)CD25(+) T cells. The CD4 positive human cells were isolated with immunomagnetic beads, and then real time-PCR was used to test the expression of FOXP3 mRNA in the CD4(+) T cells. RESULTS: In the LADA group, the percentage of CD4(+)CD25(+) T cells was 4.1 +/- 1.9, significantly higher than that of the normal control group (2.8 +/- 1.5, P < 0.01), the ratio of CD4(+)CD25(+) to the CD4(+) T cells was 11.9 +/- 5.0, significantly higher than that of the normal control group (8.2 +/- 3.7, P < 0.01), the percentage CD8(+) T cells was 24.6 +/- 6.8, significantly higher than that of the normal control group (19.4 +/- 7.1, P < 0.01) and the CD4(+)/CD8(+) ratio was 1.5 +/- 0.5, significantly lower (1.9 +/- 0.6, P < 0.01). The expression of FOXP3 mRNA in CD4(+) T cells of the LADA group was 0.52 time that of the control group (P < 0.01). The CD4(+)/CD8(+) ratio of LADA group was significantly lower that of the type 2 diabetes group (1.8 +/- 0.8, P < 0.05), however, the other results were not significantly different between these 2 groups. The percentage of was positively correlated with the titer of glutamic acid decarboxylase antibody (GADA) (r = 0.292, P < 0.05). CONCLUSION: Though the percentage of CD4(+)CD25(+) T cells and the level of CD25 expression in CD4(+) T cells are elevated, the expression of FOXP3 mRNA in CD4(+) T cells is lower. in the patients with LADA. The regulatory T cells may have defective suppressor function in patients with LADA.

Adult↗

PubMed2006

[Cross-sectional study of the relation between carboxypeptidase-H antibody and islet beta cell function in patients with latent autoimmune diabetes in adults].

OBJECTIVE: To explore the relation between carboxypeptidase-H antibody (CPH-Ab) and islet beta cell function in patients with latent autoimmune diabetes in adults (LADA) and to further confirm the diagnostic value of CPH-Ab for LADA. METHODS: Five hundred and forty-five patients who were initially diagnosed as Type 2 diabetes mellitus (T2DM) were tested with CPH-Ab and GAD-Ab by radioligand assay (RLA). T2DM patients, according to CPH-Ab and GAD-Ab status, were divided into CPH-Ab(+) group, GAD-Ab(+) group, and Ab(-) group to compare their islet beta cell function [represented by fasting C-peptide (FCP) and 2h postprandial C-peptide (2hCP)]. The relation between CPH-Ab and islet beta cell function in LADA was analyzed. RESULTS: The fasting C-peptide level in CPH-Ab(+) patients was between that of GAD-Ab(+) patients and that of Ab(-) patients (P<0.05), and the difference was still significant when the 3 groups were stratified with duration of disease (All P<0.05), but not with body mess index (all P>0.05). Corrected by concomitant variables including age, age at onset, duration of disease, and sex, the differences among the 3 groups were statistically significant (both P<0.001). Among the 3 groups FCP was lower than Ab(-) group in CPH-Ab(+) (P<0.05) and both FCP and PCP were lower than Ab(-) group in GAD-Ab(+) group (P<0.05 and P<0.01). The proportions of patients with insulin deficiency in CPH-Ab(+), GAD-Ab(+), and Ab(-) group were 27.6% (8/29), 48.1% (8/52) and 13.5% (54/400), respectively, which were significantly different among the 3 groups (P<0.001). GAD-Ab, BMI, and fasting blood glucose had effects on FCP and PCP in T2DM patients (All P<0.05), while CPH-Ab did not enter the equation in multivariable stepwise regressive analysis (P>0.05). CONCLUSION: The effect of CPH-Ab is less marked than that of GAD-Ab on islet beta-cell function in LADA patients. The value of CPH-Ab for the failure of islet beta-cell function in LADA should be determined prospectively.

Adult↗

PubMed2005

Six-year follow-up of pancreatic beta cell function in adults with latent autoimmune diabetes.

AIM: To investigate the characteristics of the progression of islet beta cell function in Chinese latent autoimmune diabetes in adult (LADA) patients with glutamic acid decarboxylase antibody (GAD-Ab) positivity, and to explore the prognostic factors for beta cell function. METHODS: Forty-five LADA patients with GAD-Ab positivity screened from phenotypic type 2 diabetic (T2DM) patients and 45 T2DM patients without GAD-Ab matched as controls were followed-up every 6 mo. Sixteen patients in LADA1 and T2DM1 groups respectively have been followed-up for 6 years, while 29 patients in LADA2 and T2DM2 groups respectively for only 1.5 years. GAD-Ab was determined by radioligand assay, and C-peptides (CP) by radioimmune assay. RESULTS: The percentage of patients whose fasting CP (FCP) decreased more than 50% compared with the baseline reached to 25.0% at 1.5(th) year in LADA1 group, and FCP level decreased (395.8+/-71.5 vs 572.8+/-72.3 pmol/L, P<0.05) at 2.5(th) year and continuously went down to the end of follow-up. No significant changes of the above parameters were found in T2DM1 group. The average decreased percentages of FCP per year in LADA and T2DM patients were 15.8% (4.0-91.0%) and 5.2% (-3.5 to 35.5%, P=0.000) respectively. The index of GAD-Ab was negatively correlated with the FCP in LADA patients (r(s)=-0.483, P=0.000). The decreased percentage of FCP per year in LADA patients were correlated with GAD-Ab index, body mass index (BMI) and age at onset (r(s)=0.408, -0.301 and -0.523 respectively, P<0.05). Moreover, GAD-Ab was the only risk factor for predicting beta cell failure in LADA patients (B=1.455, EXP (B)=4.283, P=0.023). CONCLUSION: The decreasing rate of islet beta cell function in LADA, being highly heterogeneous, is three times that of T2DM patients. The titer of GAD-Ab is an important predictor for the progression of islet beta cell function, and age at onset and BMI could also act as the predictors.

Adult↗

PubMed2005

[Clinical and immunological characteristics in rapid-onset type 1 diabetes with hyperamylasemia].

OBJECTIVE: To investigate the clinical characteristics and different status of islet autoantibodies of rapid-onset type 1 diabetes in China with elevated serum pancreatic enzymes. METHODS: In accordance with the criteria Imagawa reported, 40 cases of acute-onset type 1 diabetics with ketosis or ketoacidosis were selected and 4 fell into the criteria of rapid-onset type 1 diabetes. Compared the clinical characteristics between fulminant (group F, n = 4) and nonfulminant (group NF, n = 36) type 1 diabetics. Same parameters were compared between the patients with diabetic symptoms within 1 week (group A, n = 11) and those beyond 1week (group B, n = 29). The percentage of elevated serum amylase were compared between patients with and without severe ketoacidosis. Islet autoantibodies, including glutamic acid decarboxylase antibody (GAD-Ab), protein tyrosine phosphatase antibody (IA-2Ab) and insulin autoantibody (IAA),, were detected by radioligand assays. RESULTS: We found 4 cases of rapid-onset type 1 diabetes in Chinese, accounted for 10% of acute-onset type 1 diabetes. Among 4 rapid-onset type 1 diabetics, 2 patients detected GAD-Ab positive. Patients with duration of diabetic symptoms within 1 week (group A) were found all with severe ketoacidosis and 10 of 11 patients were found serum amylase elevated and this group appeared higher blood glucose, lower PH and CO(2)CP, nearly normal HbA(1c) and more severe ketoacidosis, more patients with elevated amylase (P < 0.05) than those with duration of symptoms more than 1 week (group B). Patients with severe ketoacidosis (n = 20) owned higher percentage of elevated serum amylase than those with mild or moderate ketoacidosis (n = 20) (60% vs 20%, P < 0.05). CONCLUSION: (1) Rapid-onset type 1 diabetes cases are also observed in China. (2) Rapid-onset type 1 diabetes may be a group of syndromes with different etiology which immune and non-immune factors may both involved in. (3) Elevated pancreatic enzymes are not specific markers for rapid-onset type 1 diabetes, it may result from severe ketoacidosis and metabolic derangements.

Autoantibodies↗

PubMed2005

[Diagnostic role of SOX13 antibody in latent autoimmune diabetes of adults].

OBJECTIVE: To explore the diagnostic role of SOX13 antibody in latent autoimmune diabetes of adults (LADA). METHODS: Sera of 328 patients with slow-onset diabetes and 120 sex and age-matched healthy controls underwent radiochemical test to detect the positive rates of SOX13-Ab, glutamic acid decarboxylace antibody (GAD-Ab) and carboxypeptidase H antibody (CPH-Ab). According to the GAD-Ab and CPH-Ab status the patients were divided into autoimmune (GAD-Ab and/or CPH-Ab positive, n = 130) and non-autoimmune (GAD-Ab and CPH-Ab negative, n = 198) diabetic subgroups. Then according to SOX13-Ab, GAD-Ab and CPH-Ab status, the diabetic patients were divided into 4 groups: SOX13-Ab positive, GAD-Ab positive, CPH-Ab positive, and antibody-negative group to compare their clinical characteristics. The effect of SOX13-Ab on islet beta-cell function was evaluated by comparison of C-peptide among the four subgroups. RESULTS: The positive rates of SOX13-Ab in the slow-onset diabetic patients (10.4%), autoimmune subgroup patients (13.1%), and non-autoimmune subgroup patients (8.6%) were all higher than that in the healthy controls (2.5%, all P < 0.05). Thirteen patients were positive for both SOX13-Ab and CPH-Ab (13/328, 4.0%), but only 2 were positive for both SOX13-Ab and GAD-Ab (2/328, 0.6%). The highest prevalence of SOX13-Ab was observed in the patients with the duration of disease ranging from 16 to 20 years. There were no differences in the clinical parameters between the SOX13-Ab positive and antibody-negative diabetic patients. CONCLUSION: SOX13-Ab testing helps improve the sensitivity of screening for LADA. SOX13-Ab positive patients tend to have a longer course of disease and varied clinical manifestations.

Adolescent↗

PubMed2004

[Etiological dissection in common anti-islet autoantibody-negative patients with type 1 diabetes].

OBJECTIVE: To explore the immunological and genetic factors of common anti-islet autoantibody-negative patients with type 1 diabetes. METHODS: Specimens of peripheral blood were collected from 33 common autoantibody (GAD-Ab, IA2-Ab, IAA, TGA and TPO-Ab) negative diabetic patients with new-onset of unprovoked ketosis (or ketoacidosis), and genome DNA was extracted. The antibodies to carboxypeptide-H (CPH) and SOX13 (ICA12) were detected by radioligand assay. The gene mutations of MODY3 (HNF-1alpha) and MODY6 (NeuroD1/Beta2) were detected by PCR-SSCP sequencing. Mitochondrial gene mutations were analyzed with PCR-RFLP. RESULTS: Two (6%) of the patients were SOX13-Ab positive, while none of them was positive for CPH-Ab. Gene mutation detection found one case of a new mutation, R321H (CGC-->CAC) in the exon 5 of HNF-1alpha gene and one case with ND1 mt3316 G-->A mutation in mitochondrial DNA. In addition to the diabetes-associated mutations described above, seven polymorphisms of HNF-1alpha gene, including L17L, I27L, L459L, S487N, IVS5 + 9 C > G, IVS6-42 G > T, and IVS7 + 7 G > A, and one NeuroD1/Beta2 gene polymorphic variant Ala45Thr, were found. CONCLUSION: Autoimmunity and gene mutations (such as MODY3 and mitochondrial genes mutations) may be etiological in a few cases initially diagnosed as autoantibody-negative type 1 diabetes. Autoimmunity and MODY and mitochondrial diabetes should be excluded if idiopathic type 1 (type 1B) diabetes is diagnosed.

Adolescent↗

PubMed2004

[Subclassification of seronegative type 1 diabetic subjects with HLA-DQ genotypes].

OBJECTIVE: To reveal the relationship between disease phenotype and HLA-DQ genotype in autoantibody-negative type 1 diabetics and to explore whether HLA-DQ genotypes can reclassify seronegative type 1 diabetic patients. METHODS: Sixty-one diabetics with unprovoked ketosis or ketoacidosis at presentation were tested for glutamic acid decarboxylase antibody (GAD-Ab), tyrosine phosphatase antibody (IA2-Ab), thyroglobulin antibody (TGA), thyroid peroxidase antibody (TPO-Ab) and HLA-DQ genotype. GAD-Ab and IA2-Ab were measured with radioligand assay. TGA and TPO-Ab were evaluated using RIA. Sequence-based genotyping (SBT) was used to determine the alleles of HLA-DQA1 and DQB1. Autoantibody negative patients were subdivided into group A (with type 1 diabetes susceptible alleles) and group B (without type 1 diabetes susceptible alleles). Clinical characteristics, including age, sex, mode of presentation, body mass index (BMI), islet beta-cell function and current treatment were compared between the autoantibody-positive and autoantibody-negative patients and between group A and B. RESULTS: Among the 61 patients, 29 (47.5%) were negative for all the antibodies tested, while 31 (50.8%) were positive for one or more antibodies tested. 5 (8.2%) were positive for all those 4 antibodies. As for genetic analysis, 18 of the 29 seronegative patients carried 1-4 HLA-DQ risk alleles, while the other 11 did not carry any type 1 diabetes susceptible alleles tested. As compared with the autoantibody-negative patients, younger age at onset, less obesity, severer degree of diabetic ketoacidosis (DKA) and lower C peptide were found in the autoantibody-positive ones. As compared with group B, less obesity [BMI: (22.4 +/- 4.4) kg/m(2) vs (25.8 +/- 3.7) kg/m(2), P = 0.03], severer degree of DKA [CO(2)CP: (16.3 +/- 7.1) mmol/L vs (19.2 +/- 2.0) mmol/L, P = 0.01; pH: 7.26 +/- 0.20 vs 7.34 +/- 0.06, P = 0.03], and lower C peptide [fasting C peptide: (254.6 +/- 189.4) pmol/L vs (458.7 +/- 274.1) pmol/L, P = 0.06] were observed in group A. During follow-up, 73% (8/11) patients in group B discontinued insulin therapy and maintained acceptable glycemic control by either diet or oral hypoglycemic agents (OHA), while only 28% (5/18) of the patients in group A discontinued and maintained control with OHA (28% vs 73%, P < 0.01). Among those who kept on using insulin, group A patients required higher insulin dosage than those of group B [(0.43 +/- 0.16) U x kg(-1) x d(-1) vs (0.24 +/- 0.18) U x kg(-1) x d(-1), P = 0.07]. CONCLUSIONS: Autoantibody-negative diabetics, if with susceptible HLA-DQ genotypes, presented more type 1A-like features, implying possible existence of as yet unidentified immunologic abnormalities in these patients. HLA-DQ risk genotypes may reclassify seronegative type 1 diabetics. Those who are autoantibody negative but carry susceptible HLA-DQ genotypes, should not be diagnosed as type 1B diabetes.

Adolescent↗

PubMed2004

[Adult-onset latent autoimmune diabetes and autoimmune thyroid disease].

OBJECTIVE: To investigate the relationship between latent autoimmune diabetes in adults (LADA) and thyroid autoimmunity. METHODS: The frequency of thyroid peroxidase antibody (TPO-Ab) and thyroglobulin antibody (TG-Ab) was determined with radioimmunoassay in 394 subjects, including 90 LADA, 104 classic type 1 diabetics (T1DM), 100 type 2 diabetics (T2DM) and 100 controls. Glutamic acid decarboxylase antibody (GAD-Ab) was measured with radioligand immunoassay. RESULTS: (1) TPO-Ab existed more frequently in LADA (16.7%, 15/90) than in T2DM patients (7.0%, 7/100; P < 0.05). The frequency of thyroid antibody (TPO-Ab or TG-Ab positivity) in LADA and T1DM was 18.9% (17/90) and 25.0% (26/104) respectively, being higher than that in the control group (8/100, 8.0%; P < 0.05). (2) Thyroid antibodies occurred more frequently in LADA patients with higher titer of GAD-Ab (GAD-Ab > or = 0.5) than those with lower ones (50.0% vs 12.5%, P < 0.05). (3) 47.1% (8/17) of LADA patients with thyroid autoimmunity had thyroid dysfunction as compared with 17.6% (6/34) in the group without thyroid antibodies (P < 0.05). CONCLUSIONS: (1) LADA patients, especially those with high titer of GAD-Ab, have high risk for thyroid autoimmunity. (2) The presence of thyroid antibody may predict high risk for thyroid dysfunction in LADA patients. (3) LADA may be one of the components in autoimmune polyendocrine syndrome.

Adolescent↗

PubMed2004

[Improved radioligand assay of insulin autoantibody].

OBJECTIVE: To establish an improved radioligand assay of insulin autoantibody (IAA) and to investigate the diagnostic role of IAA in type 1 diabetes (T1DM). METHODS: 125I-insulin antigens were mixed with sera samples in the Eppendorf tubes. The immunocomplexes were precipitated with protein A-agarose, then washed with TBST buffer and counted the cpm value using liquid scintillation counter. The assay results were expressed by IAA index and compared with those of an international standardized laboratory and a domestic anti-insulin antibody kit. Sera of 32 recent-onset type 1 diabetic patients and 120 healthy controls were screened for IAA and the consistency, sensitivity, specificity and the diagnostic value of IAA were evaluated. RESULTS: (1) The intra-assay coefficient of variation (CV) was 5.8% - 8.3%, and the inter-assay CV 7.0% - 11.0%. The IAA indices of 41 samples tested in our laboratory and in an international standardized laboratory were strongly positively related (r = 0. 783, P < 0. 01) (100.0% concordance). Arrayed according to their antibody titers, the IAA indices of 82 samples measured in our laboratory and in a domestic anti-insulin antibody kit were also strongly positively related (r = 0.982, P < 0.0001) (89.0% concordance, Kappa value 0.813), but 9 samples were positive with low titer (index 0.05 - 1.00) by the radioligand assay or negative by the kit. 2) The IAA index cut-off point was determined according to the upper limit of 99.5% percentile of 120 healthy controls. The index of 0.051 or higher was defined as positive. The IAA positivity prevalence was 18.8% (6/32) in type I diabetes and 0.8% (1/120) in the healthy controls (P < 0.001). The positivity frequency of IAA was 28.6% (4/14) in patients younger than 15 years of age and the duration less than half a year, while 11.1% (2/ 18) in those older than 15. CONCLUSION: The improved radioligand assay for IAA has a high sensitivity and specificity and can be used in clinical practice, especially for the low-titer positive subjects.

Adolescent↗

PubMed2004

[Replacement of insulin by fasting C-peptide in modified homeostasis model assessment to evaluate insulin resistance and islet beta cell function].

OBJECTIVE: To investigate the possibility of using C-peptide to replace insulin in homeostasis model assessment (Homa) to evaluate insulin resistance and islet beta cell function. METHODS: Oral glucose tolerance test (OGTT) was performed in 21 normal subjects, whose venous blood was drawn before taking glucose and 30, 60, 120 minutes after taking glucose. Insulin and C-peptide were determined with radioimmune assay. Homa indices of insulin resistance and islet beta cell function were calculated. Multiple stepwise linear regression model of insulin resistance was measured using C-peptide x blood glucose as independent variables and Homa-IR was used as the dependent variable, while the model of islet beta cell function was determined using C-peptide/(fasting blood glucose - 3.5) as the independent variable and Homaislet as the dependent variable. RESULTS: The modified Homa formula were: Homa-IR (CP) = 1.5 + fasting blood glucose x fasting C-peptide/2800 (F = 5. 511, P = 0.029), Homa-islet (CP-Normal) = 0.27 x fasting C-peptide /(fasting blood glucose - 3.5) + 50, and Homa-islet (CP-DM) = 0.27 x fasting C-Peptide/(fasting blood glucose - 3.5) (F = 212.961, P = 0.000), respectively. The modified Homa-IR (CP) and Homa-IR, Homa-islet (CP) and Homa-islet were highly correlated (r =0.689 and r = 0.788; all P = 0.000). Using Homa and modified Homa formula to evaluate the insulin resistance and islet beta cell function both in the normal and diabetic subjects was similar. CONCLUSION: Fasting C-peptide can substitute insulin in Homa model to assess insulin resistance and islet beta cell function. The modified homeostasis model assessment may be applied in the diabetics using exogenous insulin.

Adult↗

PubMed2004

[Islet beta cell function in latent autoimmune diabetes in adults with islet cell antibodies].

OBJECTIVE: To explore the predictive value and influence of islet cell antibody (ICA) and glutamic acid decarboxylase antibody (GAD-Ab) for beta cell function in latent autoimmune diabetes in adults (LADA) patients. METHODS: Fifty-six patients with initially diagnosed type 2 diabetes (including 10 cases of GAD-Ab-positive alone, 14 ICA-positive alone, 7 GAD-Ab and ICA-positive and 25 GAD-Ab and ICA negative) were followed up every 6 months (except the 2nd year) until the 5th year. Their fasting and postprandial C-peptide and glycemic control were measured. GAD-Ab was determined by radioimmunoprecipitation assay and ICA by ELISA kit. RESULTS: Decreased fasting C-peptide was found in patients with GAD-Ab alone and patients with GAD-Ab and ICA in the 2.5th year and to the end of the follow-up. The percentage of patients whose C-peptide decreased 50% or more compared with the baseline in the above 2 groups reached 60.0% in the 3nd year and 71.4% in the 3.5th year, respectively. No changes of the above parameters were found in ICA-positive alone group and GAD-Ab and ICA negative group. Complete beta-cell failure was found in 4 of the 10 patients in GAD-Ab alone group and in 1 of the 10 patients in ICA and GAD-Ab positive group. The number of failure patients in GAD-Ab alone group was more than that of the other 2 groups (P < 0.05 in both groups). There was no significant correlation between ICA index and FCP. Multiple stepwise regression analysis demonstrated that GAD-Ab contributed much more to FCP than ICA did. CONCLUSION: The islet beta cell function decreases more quickly in GAD-Ab positive LADA patients than in ICA positive ones. The titer of GAD-Ab is an important prognostic factor in islet beta cell function, and the presentation of ICA-positive alone can not predict beta cell function in LADA patients.

Adolescent↗

PubMed2004

[Changes in serum and urine ceruloplasmin concentrations in type 2 diabetes].

OBJECTIVE: To determine the changes in serum and urine ceruloplasmin (Cp) concentrations in type 2 diabetes, and to explore its clinical significance. METHODS: Cp concentrations of 57 serum samples were measured by radioimmunoassay and ratenephelometry. In the meantime, the serum and urine Cp concentrations in 110 healthy individuals and 104 type 2 diabetic patients were determined by ratenephelometry. For analysis and comparison, 104 type 2 diabetic patients were divided into imperfect glycemic control subgroup (n = 54) and perfect glycemic control subgroup (n = 50), diabetic nephropathy subgroup (n = 47) and non-diabetic nephropathy subgroup (n = 57). RESULTS: Serum Cp concentrations obtained with the radioimmunoassay and ratenephelometry methods were highly correlated and essentially indistinguishable. The cut-off point of the serum Cp concentrations was 542 mg/L and that of the ratio of Cp and creatinine was 0. 892 ng/mmol, which was determined according to the upper limit of 97.5% credit intervals or 97.5% percentile in 110 healthy individuals. Cp concentrations in type 2 diabetic patients were significantly higher than those in the healthy individuals (P <0.001). Of the type 2 diabetic patients, the imperfect glycemic subgroup had higher serum Cp concentrations than those of the perfect glycemic subgroup (P <0.01). The urine ratio of Cp and creatinine in diabetic nephropathy subgroup was significantly higher than that in non-diabetic nephropathy subgroup (P < 0.001). Urine ratio of Cp and creatinine in diagnosing diabetic nephropathy had 91.4% of sensitivity, 61.4% of specificity, and 75.0% of concordance. CONCLUSION: Detection of serum Cp levels has some reference value in understanding the state of diabetes. Combined determination of urine ratio of Cp and creatinine and ratio of albumin and creatinine is significant in the early diagnosis of diabetic nephropathy.

Adult↗

PubMed2003

Establishment and evaluation of bone mineral density reference databases appropriate for diagnosis and evaluation of osteoporosis in Chinese women.

This study was designed to establish Bone Mineral Density (BMD) Reference Databases for multiple skeletal sites appropriate for the diagnosis and evaluation of osteoporosis (OP) in Chinese women. We recruited 2702 healthy Chinese women, 5-96 years of age, for BMD assessment. BMD values at multiple skeletal sites including anteroposterior (AP) and lateral (Lat) lumbar spine, hip, and forearm were measured by dual-energy X-ray absorptiometry (DXA) using a QDR 4500A device; results were analyzed according to age group using eight regression models. BMD Reference Databases (CWD) were established according to the best regression equation and compared with Hologic reference databases for "Oriental Women" (OWD). Results indicated that the cubic regression model was superior to the quadratic, linear, logarithmic, and exponential regression models, etc. for our purpose, with a determinate coefficient ( R(2)) of 0.363-0.650 ( P = 0.000). We included 1636 female patients, aged 35-86 years, in our tests. In comparison with Hologic Reference Databases, the mean detection rate of OP in the newly established BMD Reference Databases for Chinese Women (CWD) was 16.0% +/- 2.68% lower (range, 13.7%-20.5%) at the AP spine, 16.8% +/- 11.0% lower (range, 3.5%-32.8%) at the Lat spine (except for L4), 18.7% +/- 4.6% lower (range, 12.6%-24.2%) at the hip, and 14.3% +/- 6.9% higher (range, 4.7%-24.3%) at the forearm. The difference in detection rates for OP was significant between the two reference databases ( P = 0.000), which was consistent with the differences in peak BMD values and the biological variability between them. Based upon our data, we confirmed that the Hologic BMD Reference Databases for Oriental Women (OWD) were not suitable for the diagnosis of OP in Chinese women; the BMD Reference Databases for Chinese Women (CWD) established in this study would provide reliable diagnostic standards for detection of OP in the women of South China.

Adolescent↗

PubMed2003

The effect of low dose nylestriol-levonorgestrel replacement therapy on bone mineral density in women with postmenopausal osteoporosis.

OBJECTIVE: Recently our studies have shown that nylestriol in combination with levonorgestrel prevented bone loss, decreased bone turnover rate and increased the maximal loading of bone without obvious side effects in retinoic acid (RA) induced osteoporotic rats. In addition to the animal experiments, we evaluate the effect of Compound Nylestriol Tablet (CNT) on bone mineral density (BMD) in women with postmenopausal osteoporosis. Compound Nylestriol Tablet, which contains 0.5 mg of nylestriol (cyclopentylethinyl estriol) and 0.15 mg of levonorgestrel per tablet, was authorized as a new anti-osteoporotic agent for clinical trial in postmenopausal osteoporosis. METHODS: One year's clinical observation was performed in 191 eligible patients who were randomly divided into two groups (A and B). In group A, 119 patients were treated for one year with CNT (one tablet per week) and in group B, 72 patients with placebo. Bone mineral density of lumbar antero-posterior spine (L1-L4), lateral spine, total hip and total forearm positions including radius+ulna at the ultra distal areas, mid areas, and one-third areas, were measured before and after treatment. Biochemical parameters and effects of CNT on uterus, and breast were observed. RESULTS: We found that patients treated with CNT had a significant decrease of bone loss in total forearm, including radius+ulna at the ultra distal, mid, and 1/3 areas compared with control subjects (all P < 0.05). An improved BMD tendency could be seen at the lumbar spine. There were no differences in the observed biochemical variables. No side-effects on uterus, or mammary glands observed. None of the patients had uterine bleeding or vertebral fractures during one year's CNT treatment. CONCLUSION: These data suggested that CNT is effective, safe and convenient in treating postmenopausal osteoporosis.

Aged↗

PubMed2003

[Identification of the two subtypes of latent autoimmune diabetes in adults by glutamic acid decarboxylase 65 antibody titers].

OBJECTIVE: To compare the clinical characteristics between type 2 diabetes and latent autoimmune diabetes in adults (LADA) and to define the two distinct types of LADA with different glutamic acid decarboxylase antibody (GADA) titers. METHODS: Sera of 750 patients with an initial diagnosis of type 2 diabetes mellitus (T2DM) were screened for GADA with radioimmunoprecipitation assay. The distribution and frequency of different GADA indices were described. Two hundred and ninety five patients were further studied and divided into four groups (T2DM; GADA index < 0.05; index > or = 0.5 and index > or = 0.05 but < 0.5) to compare the age of onset, body mass index, level of major component of adult hemoglobin (HbA1c) and C peptide as well as the rates of hypertension, hyperlipidemia and chronic complications. RESULTS: A total of 64 antibody-positive patients were identified. Compared with T2DM, these patients had younger age of onset, lower C peptide level (fasting C peptide 500 pmol/L vs 414 pmol/L, P < 0.01), lower body mass index (23.2 kg/m(2) vs 21.2 kg/m(2), P < 0.01) and also lower rates of hypertension (48.7% vs 31.7%, P < 0.05) and hyperlipidemia (60.2% vs 38.5%, P < 0.01). However, only the patients with high GADA titer had reduced beta cell function as compared with T2DM and low titer patients. Their diabetic complications were less than those of T2DM. Low GADA titer (index 0.05 - < 0.5) patients were similar to T2DM patients, except that they were prone to ketoacidemia. CONCLUSION: Two clinically distinct types of LADA can be identified by GADA titers. High titer GADA (GADA > or = 0.5) patients have more resemblance to insulin dependent diabetes and can be regarded as LADA-type 1 diabetes, while low titer GADA patients (0.05 - < 0.5) have clinical and metabolic phenotype of type 2 diabetes and can be regarded as LADA-type 2 diabetes.

Adult↗

PubMed2003

Glutamic acid decarboxylase 65 autoantibody levels discriminate two subtypes of latent autoimmune diabetes in adults.

OBJECTIVE: To compare the clinical characteristics between type 2 diabetes mellitus (T2DM) and latent autoimmune diabetes in adults (LADA) with different titers of glutamic acid decarboxylase autoantibody (GADA) and to define the two distinct subtypes of LADA. METHODS: Sera of 750 patients with an initial diagnosis of T2DM from central south of China were screened for GADA using a radioligand assay. The distribution and frequency of GADA levels were described. Two hundred and ninety-five patients were divided into the T2DM group (n = 233) and the LADA group (n = 62) to compare the age of onset, body mass index, HbA(1c), C-peptide, hypertension, dyslipidemia and chronic diabetic complications. Furthermore, LADA patients with different GADA titers were subdivided to analyze the same indexes as the above. RESULTS: The prevalence of LADA (defined as GADA > or = 0.05, namely GADA positive) was 9.7% in the 750 initially diagnosed type 2 diabetic patients. Compared with T2DM, LADA patients were younger at their ages of onset, had lower C-peptide and body mass index, and also had less cases with hypertension and with dyslipidemia. However, only patients with high titer of GADA had poorer beta cell functions and less diabetic complications compared to T2DM and low GADA titer of LADA patients. Patients with low GADA titer were similar to T2DM patients, except that they were prone to develop ketosis more frequently. CONCLUSIONS: Two clinically distinct subtypes of LADA can be identified by GADA levels in patients initially-diagnosed as type 2 diabetes. Patients with high titer of GADA (GADA > or = 0.5) subsequently develop more insulin dependency, which are classified as LADA-type 1; while those with lower GADA titer (0.05 < or = GADA < 0.5) and having clinical and metabolic phenotypes of type 2 diabetes are classified as LADA-type 2.

Adult↗

PubMed2003

[Metabolic syndrome and latent autoimmune diabetes in adults].

OBJECTIVE: To investigate the prevalence of metabolic syndrome (MS) in latent autoimmune diabetes in adults (LADA) and to study the positivity of glutamic acid decarboxylase autoantibody (GADA) in diabetic patients with MS. METHODS: Sera of 598 patients with an initial diagnosis of type 2 diabetes (T2DM) were screened for GADA with radioligand assay. These patients were divided into LADA and T2DM groups according to the titers of GADA to compare the prevalence of MS; the proportions of LADA in diabetic patients with and without MS were studied. We also compared the clinical characteristics of LADA patients with and without MS. RESULTS: About 23.7% of the LADA patients had MS. In patients with MS, the prevalence of LADA was 10.0%, of which approximately 95% had low GADA titers, that was, belonging to LADA-type 2. Compared with LADA patients with MS, LADA without MS were similar to classical type 1 diabetes and had features of low body weight, tendency to develop ketosis and impaired islet cell function. CONCLUSION: About 23.7% patients with MS are found in LADA patients. The GADA levels in LADA patients with and without MS are significantly different, which may need different therapeutic strategies.

Adolescent↗