Autoantibodies to Sympathetic Ganglia, GAD, or Tyrosine Phosphatase in Long-Term IDDM With and Without ECG-Based Cardiac Autonomic Neuropathy

Daniela Muhr; Ulrike Mollenhauer; Anette-Gabriele Ziegler; Manfred Haslbeck; Eberhard Standl; Oliver Schnell

doi:10.2337/diacare.20.6.1009

Original Articles

Autoantibodies to Sympathetic Ganglia, GAD, or Tyrosine Phosphatase in Long-Term IDDM With and Without ECG-Based Cardiac Autonomic Neuropathy

Daniela Muhr ,
Ulrike Mollenhauer,
Anette-Gabriele Ziegler, MD,
Manfred Haslbeck, MD ,
Eberhard Standl, MD and
Oliver Schnell, MD

Diabetes Research Institute Munich, Germany
Third Medical Department Munich, Germany
Schwabing City Hospital, Technical University Munich, Germany

Address correspondence and reprint requests to Daniela Muhr, Diabetes Research Institute, Kolner Platz 1, 80804 Munich, Germany.

Diabetes Care 1997 Jun; 20(6): 1009-1012. https://doi.org/10.2337/diacare.20.6.1009

Abstract

OBJECTIVE To evaluate the association of autoantibodies to complement-fixing sympathetic ganglia (CF-SG), and tyrosine phosphatase (IA-2) with electrocardiogram (ECG)-based cardiac autonomic neuropathy (CAN) in long-term IDDM.

RESEARCH DESIGN AND METHODS We examined the prevalence of autoantibodies to CF-SG (by complement-fixing indirect immunoflourescence), GAD, and IA-2 (by radioligand assay) and islet cells (by indirect immunofluorescence) in 96 long-term IDDM patients (41 with ECG-based CAN, ≥ 2 of 5 cardiac reflex tests abnormal; 55 without ECG-based CAN). As a control group, 89 healthy nondiabetic subjects were investigated.

RESULTS CF-SG autoantibodies were observed more frequently in long-term IDDM patients than in the control group (25 vs. 4%, P = 0.0001). Of the IDDM patients, 14 (34%) with CAN and 10 (18%) without CAN presented with CF-SG autoantibodies (P = 0.06). GAD or IA-2 autoantibodies were detected in 14 (34%) and 17 (41%) IDDM patients with CAN, compared with 24 (44%) and 29 (53%) IDDM patients without CAN (P = 0.2, P = 0.2). Islet cell antibodies were observed in 6 (15%) IDDM patients with and in 9 (16%) IDDM patients without CAN (P = 0.5).

CONCLUSIONS In long-term IDDM, the role of CF-SG autoantibodies, which tend to be more frequent in patients with ECG-based CAN, requires further investigations. The persistence of GAD and IA-2 autoantibodies is not related to ECG-based CAN.