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Autoantibodies against zinc transporter 8 are related to age and metabolic state
in patients with newly diagnosed autoimmune diabetes
#MMPMID29327148
Niechcia? E
; Rogowicz-Frontczak A
; Pi?aci?ski S
; Fichna M
; Skowro?ska B
; Fichna P
; Zozuli?ska-Zió?kiewicz D
Acta Diabetol
2018[Mar]; 55
(3
): 287-294
PMID29327148
show ga
AIMS: To assess the prevalence of ZnT8-ab and its correlation to other autoimmune
markers and diabetic ketoacidosis occurrence in children and adults with T1DM
onset. METHODS: The study included 367 patients (218 children; 149 adults) at the
T1DM onset. Selected diabetes-related autoantibodies such as GAD-ab, IA2-ab,
ZnT8-ab were tested before the initiation of insulin therapy. Diabetic
ketoacidosis was defined as glucose concentration > 13.9 mmol/l, pH < 7.30,
concentration of HCO(3) < 15 mmol/l, presence of ketone bodies in the blood and
urine. RESULTS: The autoantibodies pattern differs in both study groups. Children
were mostly positive for two (37.8%) and three (49.5%) autoantibodies, whereas
adults for one (32.2%) and two (30.7%). The most frequently detected
autoantibodies in youth were ZnT8-ab (81.1%) and IA2-ab (80.7%), while in adults
GAD-ab (74.8%). ZnT8-ab (p < 0.0001) titers were significantly higher in
children, but adults had higher titer of GAD-ab (p < 0.0001) and IA2-ab
(p < 0.0001). Children developed more frequently diabetic ketoacidosis (28.4 vs.
10.7%, p = 0.0002). ZnT8-ab (p = 0.002) and IA2-ab (p = 0.008) were reported
mostly in individuals with ketoacidosis. A correlation between the number of
positive antibodies and the severity of ketoacidosis was observed (R(s) - 0.129
p = 0.014). ZnT8-ab were associated with a greater risk of ketoacidosis
independent of gender, age group and the autoantibodies number [OR = 2.44 (95% CI
1.0-5.94), p = 0.04]. CONCLUSIONS: Children are at greater risk of ketoacidosis
at the diagnosis of diabetes. ZnT8-ab and IA2-ab are commonly detected in
children, while adults have frequently higher titer of GAD-ab. ZnT8-ab are
associated with more acute diabetes onset.
|Adolescent
[MESH]
|Adult
[MESH]
|Age Factors
[MESH]
|Aging/blood/*immunology
[MESH]
|Autoantibodies/*blood
[MESH]
|Biomarkers/analysis/metabolism
[MESH]
|Child
[MESH]
|Child, Preschool
[MESH]
|Diabetes Mellitus, Type 1/*blood/*complications/epidemiology
[MESH]
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