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Class II HLA Genotype Association With First-Phase Insulin Response Is Explained by Islet Autoantibodies.


ABSTRACT: Context:A declining first-phase insulin response (FPIR) is characteristic of the disease process leading to clinical type 1 diabetes. It is not known whether reduced FPIR depends on class II human leukocyte antigen (HLA) genotype, islet autoimmunity, or both. Objective:To dissect the role of class II HLA DR-DQ genotypes and biochemical islet autoantibodies in the compromised FPIR. Design, Setting, Participants:A total of 438 children with defined HLA DR-DQ genotype in the prospective Finnish Type 1 Diabetes Prediction and Prevention Study were analyzed for FPIR in a total of 1149 intravenous glucose tolerance tests and were categorized by their HLA DR-DQ genotype and the number of biochemical islet autoantibodies at the time of the first FPIR. Age-adjusted hierarchical linear mixed models were used to analyze repeated measurements of FPIR. Main Outcome Measure:The associations between class II HLA DR-DQ genotype, islet autoantibody status, and FPIR. Results:A strong association between the degree of risk conferred by HLA DR-DQ genotype and positivity for islet autoantibodies existed (P < 0.0001). FPIR was inversely associated with the number of biochemical autoantibodies (P < 0.0001) irrespective of HLA DR-DQ risk group. FPIR decreased over time in children with multiple autoantibodies and increased in children with no biochemical autoantibodies (P < 0.0001 and P = 0.0013, respectively). Conclusions:The class II HLA DR-DQ genotype association with FPIR was secondary to the association between HLA and islet autoimmunity. Declining FPIR was associated with positivity for multiple islet autoantibodies irrespective of class II HLA DR-DQ genotype.

SUBMITTER: Koskinen MK 

PROVIDER: S-EPMC6097602 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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Class II HLA Genotype Association With First-Phase Insulin Response Is Explained by Islet Autoantibodies.

Koskinen Maarit K MK   Lempainen Johanna J   Löyttyniemi Eliisa E   Helminen Olli O   Hekkala Anne A   Härkönen Taina T   Kiviniemi Minna M   Simell Olli O   Knip Mikael M   Ilonen Jorma J   Toppari Jorma J   Veijola Riitta R  

The Journal of clinical endocrinology and metabolism 20180801 8


<h4>Context</h4>A declining first-phase insulin response (FPIR) is characteristic of the disease process leading to clinical type 1 diabetes. It is not known whether reduced FPIR depends on class II human leukocyte antigen (HLA) genotype, islet autoimmunity, or both.<h4>Objective</h4>To dissect the role of class II HLA DR-DQ genotypes and biochemical islet autoantibodies in the compromised FPIR.<h4>Design, setting, participants</h4>A total of 438 children with defined HLA DR-DQ genotype in the p  ...[more]

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