Autoantibodies to the islet cell 65-kilodalton isoform of glutamic acid decarboxylase (GAD65) are present in most patients
with type 1 diabetes mellitus years before the clinical manifestation of the disease. GAD65 autoantibodies are also present
in a subset of patients with type 2 diabetes who frequently become insulin dependent. In the present study, we evaluated a
new, commercially available radioimmunoprecipitation assay for measuring GAD65 autoantibodies using
125I-labelled human recombinant GAD65. Results obtained with this assay were compared with those obtained by a reference assay
based on
35S-labelled recombinant GAD65. Analyses were performed on 67 patients with type 1 diabetes, 350 with type 2 diabetes, and 150
apparently healthy individuals. An excellent agreement was found between the results obtained by the
125I-GAD65 assay and those obtained by the reference method. The receiver operating characteristic (ROC) curve analysis was used
to evaluate the sensitivity and specificity of the two assays. The sensitivity of each assay was determined from the results
of the 67 type 1 patients, while the specificity was based on the 150 healthy individuals. Based on the ROC curves, the two
assays appeared identical, with a sensitivity of 84% and a clinical specificity of 98%. In conclusion, based on our results,
this simple, one-step centrifugation, high-capacity
125I-GAD65 assay has the same sensitivity and specificity as the reference assay and is highly suitable to detect GAD65 autoantibodies
in human samples.
Key words Glutamic acid decarboxylase - Autoantibodies - Diabetes mellitus - Receiver operating characteristic curve - Radioimmunoassay