Journal of Diabetes Investigation (May 2019)

Actual condition survey regarding mismatch of measurements between radioimmunoassay and enzyme‐linked immunosorbent assay tests for anti‐glutamic acid decarboxylase antibody in real‐world clinical practice

  • Yoichi Oikawa,
  • Takuma Kondo,
  • Akira Shimada,
  • Yutaka Seino,
  • Masafumi Kitaoka

DOI
https://doi.org/10.1111/jdi.12955
Journal volume & issue
Vol. 10, no. 3
pp. 685 – 689

Abstract

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Abstract Anti‐glutamic acid decarboxylase antibody (GADA) is an important islet cell‐associated autoantibody for the diagnosis of autoimmune type 1 diabetes mellitus. In Japan, the GADA assay kit was recently changed from radioimmunoassay (RIA) to enzyme‐linked immunosorbent assay (ELISA). Thereafter, a mismatched measurement between the two tests became apparent in clinical situations. The present study aimed to clarify the actual extent of mismatch between the two measurements on a larger‐scale real‐world clinical practice. In this cross‐sectional non‐local/non‐hospital‐based study, we collected anonymized data on GADA levels of 598 participants, who were simultaneously measured with GADA‐RIA and GADA enzyme‐linked immunosorbent assay tests. We found that 34% of the GADA‐RIA‐positive participants showed negative results in the GADA enzyme‐linked immunosorbent assay test; the mismatch was predominantly observed in participants with relatively low GADA‐RIA levels (<32 U/mL). This considerable mismatch might lead to physicians’ confusion in diagnosing type 1 diabetes mellitus.

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