Genetic susceptibility to non-insulin dependent diabetes mellitus and glucose intolerance are located in HLA region.
- 17 July 1993
- Vol. 307 (6897), 155-159
- https://doi.org/10.1136/bmj.307.6897.155
Abstract
OBJECTIVES--To test the hypothesis that the genetic susceptibility to non-insulin dependent diabetes mellitus is the same as that to insulin dependent disease and to see whether glucose intolerance is associated with specific HLA haplotypes. DESIGN--Population based study of men in 1989 first tested for glucose tolerance in 1984. HLA haplotypes, including HLA-A, C, B, DR, and DQ, were defined serologically. HLA haplotype data from a population based Finnish study of childhood diabetes were used for predicting non-insulin dependent diabetes and impaired glucose tolerance. SETTING--Two communities in Finland. SUBJECTS--Representative cohort of Finnish men aged 70-89, comprising 98 men with non-insulin dependent diabetes mellitus and a randomly selected group of 74 men, who served as controls, who were tested for glucose tolerance twice within five years. MAIN OUTCOME MEASURES--Non-insulin dependent diabetes, impaired glucose tolerance, blood glucose concentration. RESULTS--Diabetes associated HLA haplotypes were present in 94% (85/90) of diabetic subjects, 79% (27/34) of subjects with impaired glucose tolerance, and only 13% (3/23) of non-diabetic subjects. In this group of elderly men sensitivity of the diabetes associated HLA haplotypes for non-insulin dependent diabetes and impaired glucose tolerance was 90%, specificity 87%, and predictive power 97%. Mean fasting blood glucose concentration was only just significantly higher in men with diabetes associated haplotypes than in men with no such haplotypes, but there was a substantial difference in blood glucose values two hours after glucose loading (10.4 and 6.4 mmol/l in men with diabetes associated HLA haplotypes and men with no such haplotypes, respectively (p < 0.0001)). CONCLUSIONS--These findings support the hypothesis that specific HLA haplotypes exhibit a common genetic determinant for insulin dependent and non-insulin dependent diabetes. Furthermore, HLA is a major genetic determinant of glucose intolerance in elderly Finnish men. The belief that the HLA predisposition to diabetes is specific for insulin dependent diabetes mellitus is largely incorrect.This publication has 27 references indexed in Scilit:
- HLA haplotypes in Type 1 (insulin-dependent) diabetes mellitus: molecular analysis of the HLA-DQ locusDiabetologia, 1992
- DQA1 and DQB1 Heterodimers in Insulin-dependent Diabetes Mellitus: A Genetic-epidemiological Study in FinlandAnnals of Medicine, 1992
- NEW SUSCEPTIBILITY HAPLOTYPE FOR TYPE 1 DIABETESThe Lancet, 1989
- Risk factors and 25 year risk of coronary heart disease in a male population with a high incidence of the disease: the Finnish cohorts of the seven countries study.BMJ, 1989
- Prevalence of diabetes mellitus in elderly men aged 65 to 84 years in eastern and western FinlandDiabetologia, 1986
- LEVELS OF SOME BIOLOGICAL RISK INDICATORS AMONG ELDERLY MEN IN FINLANDAge and Ageing, 1986
- Reference Tables of Three-Locus Haplotype Frequencies and Delta Values in Caucasians, Orientals, and NegroidsPublished by Springer Science and Business Media LLC ,1984
- 1 Genetics of diabetesClinics in Endocrinology and Metabolism, 1977
- Evidence for HL-A-linked genes in "juvenile" diabetes mellitus.BMJ, 1975
- HL-A ANTIGENS AND DIABETES MELLITUSThe Lancet, 1974