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Comparison of clinical and laboratory characteristics in children with type 1 diabetes according to pancreatic autoantibodies

Korean Journal of Pediatrics 2010;53(3):414-419.
Published online March 15, 2010.
Comparison of clinical and laboratory characteristics in children with type 1 diabetes according to pancreatic autoantibodies
Ji Hae Choi1, Min Sun Kim1, Chan Jong Kim1, Jong Duk Kim2, Dae-Yeol Lee1
1Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Korea
2Department of Pediatrics, Wonkwang University School of Medicine, Iksan, Korea
췌장 자가 항체 유무에 따른 제 1형 당뇨병의 임상 및 검사 소견의 비교
최지혜1, 김민선1, 김찬종1, 김종덕2, 이대열1
1전북대학교 의학전문대학원 소아과학교실
2원광대학교 의과대학 소아과학교실
Correspondence: 
Dae-Yeol Lee, Email: leedy@chonbuk.ac.kr
Received: 5 November 2009   • Revised: 13 January 2010   • Accepted: 18 February 2010
Abstract
Purpose
The purpose of this study was to determine whether there is any difference in the clinical and laboratory characteristics of patients with autoantibody-positive and patients with autoantibody-negative type 1 diabetes at initial presentation.
Methods
We analyzed 96 patients under 18 years of age with newly diagnosed type 1 diabetes. One or both of the pancreatic autoantibodies-glutamic acid decarboxylase autoantibodies (GADA) and insulin autoantibody (IAA)-were measured in all patients, and we reviewed clinical and laboratory characteristics according to the presence of these autoantibodies.
Results
GADA was examined in 48 of 87 patients, and 55.2% of patients were positive. IAA was checked in 88 patients, and 39.8% were positive. Both GADA and IAA were measured in 83 patients, and 22.8% had both antibodies. The patients who had one or both autoantibodies (autoantibody-positive group) were younger than those not having any autoantibody (autoantibody-negative group). The autoantibody-positive group had lower BMI, corrected sodium level, and serum effective osmolarity, compared to the autoantibody-negative group (P<0.05). Similar differences were found between the GADA-positive and GADA-negative groups. However, there were no significant differences between the IAA- positive and IAA-negative groups.
Conclusion
The prevalence of pancreatic autoantibodies was significantly higher in the under-6 years age group than in the other age groups. These findings suggest that measurement of autoantibodies at the initial diagnosis of diabetes is very useful for detecting immune-mediated type 1 diabetes and providing intensive insulin therapy, especially in younger children.
Key Words: Type 1 diabetes, Children, Autoantibody


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