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首页> 外文期刊>European journal of immunogenetics: official journal of the British Society for Histocompatibility and Immunogenetics >HLA in Czech adult patients with autoimmune diabetes mellitus: comparison with Czech children with type 1 diabetes and patients with type 2 diabetes.
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HLA in Czech adult patients with autoimmune diabetes mellitus: comparison with Czech children with type 1 diabetes and patients with type 2 diabetes.

机译：捷克成人自身免疫性糖尿病患者的HLA：与捷克1型糖尿病儿童和2型糖尿病患者的比较。

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Type 1 diabetes results from an autoimmune insulitis, associated with HLA class II alleles. The evidence about HLA allele association is not clear in patients diagnosed after 35 years of age. In this study we have analyzed HLA alleles of DQB1 and DRB1 genes by sequence specific primer (SSP)-PCR technique in adult patients with disease onset after 35 years of age. Two hundred and eighty-one patients were divided into three groups according to the insulin therapy, the level of C peptide (CP), and GAD antibodies (anti-GAD). Group 1 (type 1 diabetes in adults) was characterized by CP less than 200 pmol/L and anti-GAD more or less than 50 ng/mL (n = 80). All of them had insulin therapy within 6 months after diagnosis. Group 2 latent autoimmune diabetes mellitus in adults (LADA) was defined by a minimum 6-month-long phase after diagnosis without insulin therapy, and was characterized by CP more than 200 pmol/L and anti-GAD more than 50 ng/mL (n = 70). Group 3 (type 2 diabetes) was characterized by CP more than 200 pmol/L and anti-GAD less than 50 ng/mL (n = 131). None ever had insulin therapy. In group 1, there was increased frequency of DRB1*04 (45.0% vs. controls 14.1%, OR = 5.0, P < 0.0005) and DQB1*0302 alleles (43.3% vs. controls 11.1%, OR = 6.1, P < 0.00005). There was increased frequency of DRB1*03 and DQB1*0201, and decreased frequency of DQB1*0602 (3.3% vs. controls 20.2%), but it was not significant. In group 2, there was a significantly increased frequency of DRB1*03 only (50.0% vs. controls 21.2%, OR = 3.7, P < 0.05). Compared with children with type 1 diabetes and adults with type 2 diabetes (group 3), we conclude that the presence of predisposing DQB1 alleles in adults with type 1 diabetes decreases with the age, probably due to environmental factors. Only the DRB1*03, but not the DQB1 gene, becomes the main predisposing allele in LADA patients. These findings suggest that the presence of HLA-DQB1*0302 identifies patients at high risk of requiring insulin treatment. Type 1 diabetes mellitus (DM) in children or adults may have partly different immunogenetic etiopathogenesis than LADA.
机译：1型糖尿病是由自身免疫性岛炎导致的，与HLA II类等位基因有关。在35岁以后诊断出的患者中，有关HLA等位基因关联的证据尚不清楚。在这项研究中，我们已经通过序列特异性引物（SSP）-PCR技术分析了35岁以后发病的成年患者DQB1和DRB1基因的HLA等位基因。根据胰岛素治疗，C肽（CP）水平和GAD抗体（抗GAD）水平，将281位患者分为三组。第一组（成人1型糖尿病）的特征在于CP小于200 pmol / L，抗GAD大于或小于50 ng / mL（n = 80）。所有患者均在诊断后6个月内接受了胰岛素治疗。第2组潜在的成人自身免疫性糖尿病（LADA）由诊断后至少6个月长的阶段定义，无需胰岛素治疗，其特征在于CP大于200 pmol / L，抗GAD大于50 ng / mL（ n = 70）。第3组（2型糖尿病）的特征在于CP大于200 pmol / L，抗GAD小于50 ng / mL（n = 131）。没有人曾经接受过胰岛素治疗。在第1组中，DRB1 * 04（45.0％vs.对照14.1％，OR = 5.0，P <0.0005）和DQB1 * 0302等位基因（43.3％vs. 11.1％，OR = 6.1，P <0.00005）的发生率增加）。 DRB1 * 03和DQB1 * 0201的频率增加，而DQB1 * 0602的频率降低（3.3％，而对照为20.2％），但不显着。在第2组中，仅DRB1 * 03的频率显着增加（50.0％，而对照组为21.2％，OR = 3.7，P <0.05）。与1型糖尿病儿童和2型糖尿病成人（第3组）相比，我们得出的结论是1型糖尿病成人中易感DQB1等位基因的存在随着年龄的增长而减少，这可能是由于环境因素所致。在LADA患者中，只有DRB1 * 03而非DQB1基因成为主要的易感等位基因。这些发现表明，HLA-DQB1 * 0302的存在确定了需要胰岛素治疗的高风险患者。儿童或成人的1型糖尿病（DM）可能具有与LADA不同的免疫遗传病因。

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