{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T02:58:41Z","timestamp":1790218721750,"version":"4.1.0"},"reference-count":51,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,11,14]],"date-time":"2021-11-14T00:00:00Z","timestamp":1636848000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Insulin autoimmune syndrome (IAS) is the third most common cause of spontaneous hypoglycaemia in Japan but very rare in the rest of the world. We aimed to identify factors, which are associated with the occurrence of IAS and which may differ between East Asian and non\u2010East Asian patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A PubMed search using the search terms \u2018insulin autoimmune syndrome\u2019 and \u2018Hirata disease\u2019 revealed a total of 287 reports of IAS cases, including one previously unpublished own case.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean age (\u00b1standard deviation) was 52\u2009\u00b1\u200919 years in East Asian and 54\u2009\u00b1\u200921 years in non\u2010East Asian patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u2009.05). In both groups, there were more females. Mean body mass index was lower in East Asian than in non\u2010East Asian patients (23.0\u2009\u00b1\u20094.3 vs. 27.1\u2009\u00b1\u20095.6\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.0001). Postprandial hypoglycaemia was more common in non\u2010East Asian patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.05). East Asian patients took more frequently antithyroid medications and non\u2010East Asian patients angiotensin\u2010converting enzyme (ACE) inhibitors (both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.0001). Graves' disease and other autoimmune diseases were more frequently observed in East Asian patients (both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.01). Parameters of glucose metabolism were comparable in both groups, independent of diabetes diagnosis (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u2009.05), except for insulin that was higher in East Asian compared to non\u2010East Asian metabolically healthy patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.01). Human leukocyte antigen (HLA)\u2010DRB1*0406 was the most frequent HLA\u2010type in East Asian patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.0001), whereas DRB1*0403 and *0404 were more frequent in non\u2010East Asian patients (both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.05). Non\u2010East Asian patients received more secondary treatments, including plasmapheresis and rituximab, whereas medication discontinuation was more common in East Asian patients (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.05). Outcome was similar in both groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u2009.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Factors associated with IAS markedly differ between East Asian and non\u2010East Asian patients, with autoimmune disorders, particularly Graves' disease, antithyroid medications, and HLA\u2010DRB1*0406 more prevalent in East Asian patients and cardiovascular and plasma cell diseases, ACE inhibitors and HLA\u2010DRB1*0403 more prevalent in non\u2010East Asian patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cen.14634","type":"journal-article","created":{"date-parts":[[2021,11,14]],"date-time":"2021-11-14T23:14:22Z","timestamp":1636931662000},"page":"328-338","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Comparison of patient characteristics between East Asian and non\u2010East Asian patients with insulin autoimmune syndrome"],"prefix":"10.1111","volume":"96","author":[{"given":"Lisa","family":"Oest","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Heinrich Heine University D\u00fcsseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Roden","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Heinrich Heine University D\u00fcsseldorf Germany"},{"name":"Institute for Clinical Diabetology, German Diabetes Center Leibniz Center for Diabetes Research at Heinrich Heine University D\u00fcsseldorf D\u00fcsseldorf Germany"},{"name":"German Center for Diabetes Research (DZD), Partner D\u00fcsseldorf M\u00fcnchen\u2010Neuherberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0107-1196","authenticated-orcid":false,"given":"Karsten","family":"M\u00fcssig","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Heinrich Heine University D\u00fcsseldorf Germany"},{"name":"Institute for Clinical Diabetology, German Diabetes Center Leibniz Center for Diabetes Research at Heinrich Heine University D\u00fcsseldorf D\u00fcsseldorf Germany"},{"name":"German Center for Diabetes Research (DZD), Partner D\u00fcsseldorf M\u00fcnchen\u2010Neuherberg Germany"},{"name":"Department of Internal Medicine and Gastroenterology Niels Stensen Hospitals, Franziskus Hospital Harderberg Georgsmarienh\u00fctte Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,11,14]]},"reference":[{"key":"e_1_2_18_2_1","doi-asserted-by":"publisher","DOI":"10.1515\/cclm-2017-0392"},{"key":"e_1_2_18_3_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.77.1.249"},{"key":"e_1_2_18_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-013-2588-9"},{"key":"e_1_2_18_5_1","doi-asserted-by":"publisher","DOI":"10.21037\/atm.2018.07.32"},{"key":"e_1_2_18_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.13180"},{"key":"e_1_2_18_7_1","doi-asserted-by":"publisher","DOI":"10.2147\/DMSO.S219438"},{"key":"e_1_2_18_8_1","first-page":"130086","article-title":"Analytical and clinical challenges in a patient with concurrent type 1 diabetes, subcutaneous insulin resistance and insulin autoimmune syndrome","volume":"2014","author":"Jassam N","year":"2014","journal-title":"Endocrinol Diabetes Metab Case Rep"},{"key":"e_1_2_18_9_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2001-15113"},{"key":"e_1_2_18_10_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2004-824862"},{"key":"e_1_2_18_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.12334"},{"key":"e_1_2_18_12_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpem-2013-0215"},{"key":"e_1_2_18_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/2042018816658396"},{"key":"e_1_2_18_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(83)91193-5"},{"key":"e_1_2_18_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nut.2018.04.010"},{"key":"e_1_2_18_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(85)90294-3"},{"key":"e_1_2_18_17_1","doi-asserted-by":"publisher","DOI":"10.2147\/IMCRJ.S190908"},{"key":"e_1_2_18_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/0961203308098188"},{"key":"e_1_2_18_19_1","first-page":"4539","article-title":"Autoimmune insulin syndrome. 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