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Experimental Diabetes Research
Volume 2011, Article ID 964160, 6 pages
http://dx.doi.org/10.1155/2011/964160
Clinical Study

HLA Class II Alleles Susceptibility Markers of Type 1 Diabetes Fail to Specify Phenotypes of Ketosis-Prone Diabetes in Adult Tunisian Patients

1Immunology Department, La Rabta Hospital and Al Manar University Tunis, 1007 Tunis, Tunisia
2Endocrinology Department, La Rabta Hospital and Al Manar University Tunis, 1007 Tunis, Tunisia
3Biochemistry Department, La Rabta Hospital and Al Manar University Tunis, 1007 Tunis, Tunisia

Received 8 October 2010; Revised 28 December 2010; Accepted 10 January 2011

Academic Editor: A. Veves

Copyright © 2011 Lilia Laadhar et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We aimed to characterize the different subgroups of ketosis-prone diabetes (KPD) in a sample of Tunisian patients using the Aβ scheme based on the presence or absence of β-cell autoantibodies (A+ or A−) and β-cell functional reserve (β+ or β−) and we investigated whether HLA class II alleles could contribute to distinct KPD phenotypes. We enrolled 43 adult patients with a first episode of ketosis. For all patients we evaluated clinical parameters, β-cell autoimmunity, β-cell function and HLA class II alleles. Frequency distribution of the 4 subgroups was 23.3% A+β−, 23.3% A−β−, 11.6% A+β+ and 41.9% A−β+. Patients from the group A+β− were significantly younger than those from the group A−β− ( ). HLA susceptibility markers were significantly more frequent in patients with autoantibodies ( ). These patients also had resistance alleles but they were more frequent in A+β+ than A+β− patients ( ). Insulin requirement was not associated to the presence or the absence of HLA susceptibility markers. HLA class II alleles associated with susceptibility to autoimmune diabetes have not allowed us to further define Tunisian KPD groups. However, high prevalence of HLA resistance alleles in our patients may reflect a particular genetic background of Tunisian KPD population.