Islet Cell Associated Autoantibodies and C-Peptide Levels in Patients with Diabetes and Symptoms of Gastroparesis
IntroductionIndividuals with diabetes are at increased risk for complications, including gastroparesis. Type 1 diabetes mellitus (T1DM) is an autoimmune disorder resulting in decreased beta-cell function. Glutamic acid decarboxylase-65 antibody (GADA) is the most commonly used test to assess autoimm...
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doaj-6bed0f1115444ce1833356b4ae4df2862020-11-24T21:02:28ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922018-02-01910.3389/fendo.2018.00032318052Islet Cell Associated Autoantibodies and C-Peptide Levels in Patients with Diabetes and Symptoms of GastroparesisElias S. Siraj0Carol Homko1Laura A. Wilson2Patrick May3Ajay D. Rao4Jorge Calles5Gianrico Farrugia6William L. Hasler7Kenneth L. Koch8Linda Nguyen9William J. Snape10Thomas L. Abell11Irene Sarosiek12Richard W. McCallum13Pankaj J. Pasricha14John Clarke15James Tonascia16Frank Hamilton17Henry P. Parkman18Division of Endocrinology and Metabolic Disorders, Eastern Virginia Medical School, Norfolk, VA, United StatesLewis Katz School of Medicine, Temple University, Philadelphia, PA, United StatesJohns Hopkins University, Baltimore, MD, United StatesJohns Hopkins University, Baltimore, MD, United StatesLewis Katz School of Medicine, Temple University, Philadelphia, PA, United StatesCase Western Reserve University, Cleveland, OH, United StatesMayo Clinic, Rochester, NY, United StatesUniversity of Michigan, Ann Arbor, MI, United StatesWake Forest University, Winston-Salem, NC, United StatesStanford University, Palo Alto, CA, United StatesCalifornia Pacific Medical Center, San Francisco, CA, United States0University of Louisville, Louisville, KY, United States1Texas Tech University Health Science Center, El Paso, TX, United States1Texas Tech University Health Science Center, El Paso, TX, United StatesJohns Hopkins University, Baltimore, MD, United StatesJohns Hopkins University, Baltimore, MD, United StatesJohns Hopkins University, Baltimore, MD, United States2National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, United StatesLewis Katz School of Medicine, Temple University, Philadelphia, PA, United StatesIntroductionIndividuals with diabetes are at increased risk for complications, including gastroparesis. Type 1 diabetes mellitus (T1DM) is an autoimmune disorder resulting in decreased beta-cell function. Glutamic acid decarboxylase-65 antibody (GADA) is the most commonly used test to assess autoimmunity while C-peptide level is used to assess beta-cell function. Patients with type 2 diabetes mellitus (T2DM), who are GADA positive, are labeled latent autoimmune diabetes in adults (LADA).ObjectiveTo characterize patients with T1 and T2DM who have symptoms of gastroparesis using GADA and C-peptide levels and to look for association with the presence of gastroparesis and its symptom severity.Design113 T1DM and 90 T2DM patients with symptoms suggestive of gastroparesis were studied. Symptom severity was assessed using Gastroparesis Cardinal Symptom Index (GCSI). Serum samples were analyzed for GADA and C-peptide.ResultsDelayed gastric emptying was present in 91 (81%) of T1DM and 60 (67%) of T2DM patients (p = 0.04). GADA was present in 13% of T2DM subjects [10% in delayed gastric emptying and 20% in normal gastric emptying (p = 0.2)]. Gastric retention and GCSI scores were mostly similar in GADA positive and negative T2DM patients. GADA was present in 45% of T1DM subjects [46% in delayed gastric emptying and 41% in normal gastric emptying (p = 0.81)]. Low C-peptide levels were seen in 79% T1DM patients and 8% T2DM. All seven T2DM patients with low C-peptide were taking insulin compared to 52% of T2DM with normal C-peptide.ConclusionGADA was present in 13% while low C-peptide was seen in 8% of our T2DM patients with symptoms of gastroparesis. Neither did correlate with degree of delayed gastric emptying or symptom severity.ClinicalTrials.gov IdentifierNCT01696747.http://journal.frontiersin.org/article/10.3389/fendo.2018.00032/fullGADGAD65GAD65 antibodiesislet cell antibodiesC-peptidegastroparesis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Elias S. Siraj Carol Homko Laura A. Wilson Patrick May Ajay D. Rao Jorge Calles Gianrico Farrugia William L. Hasler Kenneth L. Koch Linda Nguyen William J. Snape Thomas L. Abell Irene Sarosiek Richard W. McCallum Pankaj J. Pasricha John Clarke James Tonascia Frank Hamilton Henry P. Parkman |
spellingShingle |
Elias S. Siraj Carol Homko Laura A. Wilson Patrick May Ajay D. Rao Jorge Calles Gianrico Farrugia William L. Hasler Kenneth L. Koch Linda Nguyen William J. Snape Thomas L. Abell Irene Sarosiek Richard W. McCallum Pankaj J. Pasricha John Clarke James Tonascia Frank Hamilton Henry P. Parkman Islet Cell Associated Autoantibodies and C-Peptide Levels in Patients with Diabetes and Symptoms of Gastroparesis Frontiers in Endocrinology GAD GAD65 GAD65 antibodies islet cell antibodies C-peptide gastroparesis |
author_facet |
Elias S. Siraj Carol Homko Laura A. Wilson Patrick May Ajay D. Rao Jorge Calles Gianrico Farrugia William L. Hasler Kenneth L. Koch Linda Nguyen William J. Snape Thomas L. Abell Irene Sarosiek Richard W. McCallum Pankaj J. Pasricha John Clarke James Tonascia Frank Hamilton Henry P. Parkman |
author_sort |
Elias S. Siraj |
title |
Islet Cell Associated Autoantibodies and C-Peptide Levels in Patients with Diabetes and Symptoms of Gastroparesis |
title_short |
Islet Cell Associated Autoantibodies and C-Peptide Levels in Patients with Diabetes and Symptoms of Gastroparesis |
title_full |
Islet Cell Associated Autoantibodies and C-Peptide Levels in Patients with Diabetes and Symptoms of Gastroparesis |
title_fullStr |
Islet Cell Associated Autoantibodies and C-Peptide Levels in Patients with Diabetes and Symptoms of Gastroparesis |
title_full_unstemmed |
Islet Cell Associated Autoantibodies and C-Peptide Levels in Patients with Diabetes and Symptoms of Gastroparesis |
title_sort |
islet cell associated autoantibodies and c-peptide levels in patients with diabetes and symptoms of gastroparesis |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Endocrinology |
issn |
1664-2392 |
publishDate |
2018-02-01 |
description |
IntroductionIndividuals with diabetes are at increased risk for complications, including gastroparesis. Type 1 diabetes mellitus (T1DM) is an autoimmune disorder resulting in decreased beta-cell function. Glutamic acid decarboxylase-65 antibody (GADA) is the most commonly used test to assess autoimmunity while C-peptide level is used to assess beta-cell function. Patients with type 2 diabetes mellitus (T2DM), who are GADA positive, are labeled latent autoimmune diabetes in adults (LADA).ObjectiveTo characterize patients with T1 and T2DM who have symptoms of gastroparesis using GADA and C-peptide levels and to look for association with the presence of gastroparesis and its symptom severity.Design113 T1DM and 90 T2DM patients with symptoms suggestive of gastroparesis were studied. Symptom severity was assessed using Gastroparesis Cardinal Symptom Index (GCSI). Serum samples were analyzed for GADA and C-peptide.ResultsDelayed gastric emptying was present in 91 (81%) of T1DM and 60 (67%) of T2DM patients (p = 0.04). GADA was present in 13% of T2DM subjects [10% in delayed gastric emptying and 20% in normal gastric emptying (p = 0.2)]. Gastric retention and GCSI scores were mostly similar in GADA positive and negative T2DM patients. GADA was present in 45% of T1DM subjects [46% in delayed gastric emptying and 41% in normal gastric emptying (p = 0.81)]. Low C-peptide levels were seen in 79% T1DM patients and 8% T2DM. All seven T2DM patients with low C-peptide were taking insulin compared to 52% of T2DM with normal C-peptide.ConclusionGADA was present in 13% while low C-peptide was seen in 8% of our T2DM patients with symptoms of gastroparesis. Neither did correlate with degree of delayed gastric emptying or symptom severity.ClinicalTrials.gov IdentifierNCT01696747. |
topic |
GAD GAD65 GAD65 antibodies islet cell antibodies C-peptide gastroparesis |
url |
http://journal.frontiersin.org/article/10.3389/fendo.2018.00032/full |
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