| Hyperproinsulinemia segregates young adult patients with newly diagnosed autoimmune (type 1) and non-autoimmune (type 2) diabetes. | |
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MedLine Citation:
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PMID: 16271990 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To investigate whether measurements of proinsulin and/or intermediate proinsulin degradation products could be used to differentiate between autoimmune (type 1) and non-autoimmune (type 2) diabetes in young adults. MATERIAL AND METHODS: Total proinsulin, intact proinsulin and 32,33 split proinsulin concentrations were measured in 25 patients aged 15-34 years with type 1 diabetes, as defined by the presence of at least two positive islet autoantibodies, and in 23 antibody-negative patients of similar age with type 2 diabetes, at the time of clinical onset of diabetes and at 3-4 months thereafter. Comparisons were made with data from 25 healthy subjects matched for gender and age. RESULTS: Plasma levels of total proinsulin, intact proinsulin and 32,33 split proinsulin were significantly increased 2-3-fold in the patients with newly diagnosed type 2 diabetes as compared with the controls, both in absolute terms (p<0.0001) and when related to circulating insulin (p<0.01-0.0002). In contrast, absolute proinsulin and 32,33 split proinsulin concentrations were significantly lower in patients with onset of type 1 diabetes than in controls. When proinsulin and split proinsulin release were related to plasma insulin, however, similar ratios were found in the type 1 diabetes patients and in controls. Using the 90th percentile for total proinsulin in the control group as the cut-off, the sensitivity and specificity for differentiation between autoimmune and non-autoimmune diabetes were 87% and 92%, respectively. At 3-4 months after clinical onset of diabetes, proinsulin secretion was still 2-3 times higher in type 2 than in type 1 diabetes patients (p<0.001). CONCLUSIONS: Young adult patients with newly diagnosed type 2 diabetes display disproportionate hyperproinsulinemia, whereas proinsulin secretion appears to be normal in patients with clinical onset of type 1 diabetes. Evaluation of proinsulin and 32,33 split proinsulin concentrations may be useful as a diagnostic tool in differentiating between autoimmune and non-autoimmune diabetes in young adults, particularly in those lacking islet autoantibodies at diagnosis. |
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Authors:
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J Bolinder; P Fernlund; H Borg; H J Arnqvist; E Björk; G Blohmé; J W Eriksson; L Nyström; J Ostman; G Sundkvist |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Scandinavian journal of clinical and laboratory investigation Volume: 65 ISSN: 0036-5513 ISO Abbreviation: Scand. J. Clin. Lab. Invest. Publication Date: 2005 |
Date Detail:
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Created Date: 2005-11-07 Completed Date: 2006-12-01 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0404375 Medline TA: Scand J Clin Lab Invest Country: Norway |
Other Details:
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Languages: eng Pagination: 585-94 Citation Subset: IM |
Affiliation:
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Department of Medicine, Karolinska University Hospital Huddinge. jan.bolinder@medhs.ki.se |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Diabetes Mellitus, Type 1 / blood, complications*, diagnosis* Diabetes Mellitus, Type 2 / blood, complications*, diagnosis* Female Humans Hyperinsulinism / blood, complications*, diagnosis* Insulin / blood Male |
| Chemical | |
Reg. No./Substance:
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11061-68-0/Insulin |
| Comments/Corrections | |
Comment In:
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Scand J Clin Lab Invest. 2006;66(1):5-6
[PMID:
16464781
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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