Diabetes and rheumatoid factor

Organ-specific autoantibodies in non-organ-specific autoimmune diseases with special reference to rheumatoid arthritis

Sera from 367 patients with rheumatoid arthritis (RA) and from 102 patients with other non-organ-specific (NOS) autoimmune diseases were examined for the presence of organ-specific (OS) autoantibodies. The incidence of these OS autoantibodies was not increased in patients with NOS autoimmune diseases with the exception of thyroglobulin antibodies, which were significantly more frequent in RA (P less than 0.001) and in Sjögren's syndrome (P less than 0.05) patients than in normal controls. Investigation of 169 patients with OS autoimmune diseases did not reveal an increased prevalence of NOS autoantibodies. In RA patients, OS autoantibodies correlated with NOS autoantibodies (P less than 0.04) and with HLA-DR3 antigen (P less than 0.01).

Host and environmental interactions in diabetes mellitus

A number of current issues in diabetes research are reviewed from an epidemiologic viewpoint. Though many advances have been made in our understanding of the causes of insulin-dependent diabetes mellitus (IDDM), there are many unresolved issues which could benefit from epidemiologic research. These include study of the 36-fold geographic variation in IDDM incidence seen across the world, perhaps by the development of registries, and the placing into a population perspective recent genetic and autoimmune findings concerning IDDM etiology. Epidemiologic considerations should also be incorporated into future trials of immunotherapy for IDDM. Despite considerable research, very little is known about risk factors and genetic environmental interactions in non-insulin dependent diabetes. Large scale prospective epidemiologic studies are, therefore, needed to delineate the potential roles of factors such as diet and physical activity, and how these interact with genetic predisposition.