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Islet Cell Associated Autoantibodies and C-Peptide Levels in Patients with Diabetes and Symptoms of Gastroparesis

INTRODUCTION: Individuals 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 autoi...

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Autores principales: Siraj, Elias S., Homko, Carol, Wilson, Laura A., May, Patrick, Rao, Ajay D., Calles, Jorge, Farrugia, Gianrico, Hasler, William L., Koch, Kenneth L., Nguyen, Linda, Snape, William J., Abell, Thomas L., Sarosiek, Irene, McCallum, Richard W., Pasricha, Pankaj J., Clarke, John, Tonascia, James, Hamilton, Frank, Parkman, Henry P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5816742/
https://www.ncbi.nlm.nih.gov/pubmed/29487566
http://dx.doi.org/10.3389/fendo.2018.00032
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author Siraj, Elias S.
Homko, Carol
Wilson, Laura A.
May, Patrick
Rao, Ajay D.
Calles, Jorge
Farrugia, Gianrico
Hasler, William L.
Koch, Kenneth L.
Nguyen, Linda
Snape, William J.
Abell, Thomas L.
Sarosiek, Irene
McCallum, Richard W.
Pasricha, Pankaj J.
Clarke, John
Tonascia, James
Hamilton, Frank
Parkman, Henry P.
author_facet Siraj, Elias S.
Homko, Carol
Wilson, Laura A.
May, Patrick
Rao, Ajay D.
Calles, Jorge
Farrugia, Gianrico
Hasler, William L.
Koch, Kenneth L.
Nguyen, Linda
Snape, William J.
Abell, Thomas L.
Sarosiek, Irene
McCallum, Richard W.
Pasricha, Pankaj J.
Clarke, John
Tonascia, James
Hamilton, Frank
Parkman, Henry P.
author_sort Siraj, Elias S.
collection PubMed
description INTRODUCTION: Individuals 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). OBJECTIVE: To 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. DESIGN: 113 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. RESULTS: Delayed 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. CONCLUSION: GADA 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 IDENTIFIER: NCT01696747.
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spelling pubmed-58167422018-02-27 Islet Cell Associated Autoantibodies and C-Peptide Levels in Patients with Diabetes and Symptoms of Gastroparesis Siraj, Elias S. Homko, Carol Wilson, Laura A. May, Patrick Rao, Ajay D. Calles, Jorge Farrugia, Gianrico Hasler, William L. Koch, Kenneth L. Nguyen, Linda Snape, William J. Abell, Thomas L. Sarosiek, Irene McCallum, Richard W. Pasricha, Pankaj J. Clarke, John Tonascia, James Hamilton, Frank Parkman, Henry P. Front Endocrinol (Lausanne) Endocrinology INTRODUCTION: Individuals 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). OBJECTIVE: To 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. DESIGN: 113 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. RESULTS: Delayed 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. CONCLUSION: GADA 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 IDENTIFIER: NCT01696747. Frontiers Media S.A. 2018-02-13 /pmc/articles/PMC5816742/ /pubmed/29487566 http://dx.doi.org/10.3389/fendo.2018.00032 Text en Copyright © 2018 Siraj, Homko, Wilson, May, Rao, Calles, Farrugia, Hasler, Koch, Nguyen, Snape, Abell, Sarosiek, McCallum, Pasricha, Clarke, Tonascia, Hamilton and Parkman. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Endocrinology
Siraj, Elias S.
Homko, Carol
Wilson, Laura A.
May, Patrick
Rao, Ajay D.
Calles, Jorge
Farrugia, Gianrico
Hasler, William L.
Koch, Kenneth L.
Nguyen, Linda
Snape, William J.
Abell, Thomas L.
Sarosiek, Irene
McCallum, Richard W.
Pasricha, Pankaj J.
Clarke, John
Tonascia, James
Hamilton, Frank
Parkman, Henry P.
Islet Cell Associated Autoantibodies and C-Peptide Levels in Patients with Diabetes and Symptoms of Gastroparesis
title 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_short 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
topic Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5816742/
https://www.ncbi.nlm.nih.gov/pubmed/29487566
http://dx.doi.org/10.3389/fendo.2018.00032
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