Autoantibody “Subspecificity” in Type 1 Diabetes

Barker, Jennifer M.; Yu, Jeesuk; Yu, Liping; Wang, Jian; Miao, Dongmei; Bao, Fei; Hoffenberg, Edward J.; Nelson, Jerald C.; Gottlieb, Peter A.; Rewers, Marian; Eisenbarth, George S.

doi:10.2337/diacare.28.4.850

Cited by 163 publications

(129 citation statements)

References 42 publications

(26 reference statements)

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“…According to the literature, the prevalence of anti-TPO is estimated to be between 15% and 30% in adults and 5% to 22% in children with DM 1, whereas its prevalence in the general population is found to be 10-13% and 1-4% respectively [1,16]. However, in the quoted studies the mean diabetes duration was only 3.4 years.…”

Section: Fig 1 Prevalence Of Anti-tpo According To Tsh After Excludmentioning

confidence: 67%

Prevalence of Anti-Thyroid Peroxidase in Adults with Type 1 Diabetes Participating in Poznań Prospective Study

et al. 2015

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Background. Type 1 diabetes (DM 1) is frequently associated with autoimmune thyroid diseases (AITD). Screening for AITD in adults is rarely performed. The aim of this study was to evaluate the prevalence of anti-thyroid peroxidase (anti-TPO) and thyroid function and their association with metabolic control in adults participating in Poznan Prospective Study (PoProStu). Material and Methods. The analysis included 74 patients (26 women and 48 men) aged 38.5 (IQR: 34.5-42.5), who have had diabetes for 15.0 (14-16) years. All patients have been treated with intensive functional insulin therapy (IFIT) from the onset of the disease. Anti-TPO and thyroid-stimulating hormone (TSH) were determined. The concentration of anti-TPO ≥ 5.61 IU/mL was considered positive. Based on the levels of anti-TPO the patients were divided into two groups: anti-TPO positive and anti-TPO negative. Metabolic control was assessed by the level of glycated hemoglobin (HbA 1c ). Results. Anti-TPO was positive in 32 (43.2%) patients. Prevalence of autoantibodies was significantly higher in women (53% vs 21%; p = 0.009). There was no significant difference in HbA 1c levels [median (IQR): 7.6% (7.1-8.6) vs 7.6% (7.1-8.8); p = 0.82] and TSH levels [median (IQR): 2.05 µIU/mL (1.23-3.15) vs 1.62 µIU/mL (1.00-2.10); p = 0.06] between anti-TPO positive and negative patients. After excluding patients with a thyroid dysfunction, a significant difference in TSH levels between anti-TPO positive and negative group was found [median (IQR): 2.11 µIU/mL (1.29-3.31) vs 1.66 µIU/mL (1.29-3.31); p = 0.04]. Conclusions. High anti-TPO prevalence is found in adult patients with long-standing DM 1, and autoantibodies occur more often in women. Therefore, screening for asymptomatic thyroid dysfunction should be performed in this group, as already recommended by the joint statement of Polish Society of Endocrinology and Diabetes Poland (Adv Clin Exp Med 2015, 24, 1, 79-84).

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Section: Fig 1 Prevalence Of Anti-tpo According To Tsh After Excludmentioning

confidence: 67%

Prevalence of Anti-Thyroid Peroxidase in Adults with Type 1 Diabetes Participating in Poznań Prospective Study

et al. 2015

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“…An association between AITD and HLA-DR3 [36], HLA-DR4 [24,37] and DRB1*04-DQB1*03:01 [38] has been reported. In addition, HLA-DR3 and DR3/DQB1*03:02 has also been reported to contribute to both type 1 diabetes and AITD in a study of families with both diseases, while DR4 was associated with type 1 diabetes but not with AITD [25,28,39]. Others have failed to find an association between HLA and TPOAb [1].…”

Section: Discussionmentioning

confidence: 89%

“…Our prevalence of thyroid autoantibodies at clinical onset of type 1 diabetes was similar to findings in some previous studies [26,27], but in other studies a prevalence as high as 15.8-29% has been reported. However, in these studies, the patients were tested at follow-up and not at the time of diagnosis [1,13,14,[28][29][30], which may explain the higher prevalence. Furthermore, only few children are diagnosed with AITD at the onset of type 1 diabetes [23,26,31], while the risk of AITD increases during follow-up of patients with type 1 diabetes.…”

Section: Discussionmentioning

confidence: 99%

Thyroid autoimmunity in relation to islet autoantibodies and HLA-DQ genotype in newly diagnosed type 1 diabetes in children and adolescents

et al. 2013

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Aims/hypothesis The aim of this work was to investigate, in children newly diagnosed with type 1 diabetes: (1) the prevalence of autoantibodies against thyroid peroxidase (TPOAb) and thyroglobulin (TGAb); and (2) the association between TPOAb, TGAb or both, with either islet autoantibodies or HLA-DQ genes. Methods Blood samples from 2,433 children newly diagnosed with type 1 diabetes were analysed for TPOAb and TGAb in addition to autoantibodies against arginine zinc transporter 8 (ZnT8RA), tryptophan zinc transporter 8 (ZnT8WA), glutamine zinc transporter 8 (ZnT8QA), glutamic acid decarboxylase (GADA), insulin (IAA), insulinoma-associated protein-2 (IA-2A), HLA-DQA-B1 genotypes, thyroid-stimulating hormone (TSH) and free thyroxine (T4). Results At type 1 diabetes diagnosis, 12% of the children had thyroid autoantibodies (60% were girls; p<0.0001). GADA was positively associated with TPOAb (p<0.001) and with TGAb (p<0.001). In addition, ZnT8A was associated with both TPOAb (p=0.039) and TGAb (p=0.015). DQB1*05:01 in any genotype was negatively associated with TPOAb (OR 0.55, 95% CI 0.37, 0.83, p value corrected for multiple comparisons (p c )=0.012) and possibly with TGAb (OR 0.55, 95% CI 0.35, 0.87, p c =0.07). Thyroid autoimmunity in children newly diagnosed with type 1 diabetes was rarely (0.45%) associated with onset of clinical thyroid disease based on TSH and free T4. Conclusions/interpretation GADA and ZnT8A increased the risk for thyroid autoimmunity at the time of clinical diagnosis of type 1 diabetes, while HLA-DQB1*05:01 reduced the risk. However, the associations between thyroid autoimmunity and HLA-DQ genotype were weak and did not fully explain the co-occurrence of islet and thyroid autoimmunity.

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“…The reported prevalence of thyroid autoimmunity in young T1DM patients ranges between 3% and 50% [10,[30][31][32][33], while it is 3.4%-7% in the general paediatric population [34,35]. The association of T1DM and AITD is highly dependent on age, sex and ethnicity [36]. Approximately 10% of T1DM patients are affected by CD with prevalence ranging from 0.6% to 16.4% reported in different studies [10,[37][38][39] and that is significantly higher than in non-diabetic children (1%-2% of the population).…”

Section: Discussionmentioning

confidence: 99%

Organ-specific autoimmunity in relation to clinical characteristics in children with long-lasting type 1 diabetes

Głowińska‐Olszewska

Michalak

Łuczyński

et al. 2016

Journal of Pediatric Endocrinology and Metabolism

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Background: The aim of this study was to assess the prevalence of diabetes and other organ-specific autoantibodies (Ab) associated with various autoimmune conditions, in Polish children with type 1 diabetes mellitus (T1DM). Methods: In this study 114 patients, aged 13.4 years, with mean diabetes duration 5.2 years were included. Ab to islet cell antigens: glutamic acid decarboxylase (GAD), insulinoma antigen 2 (IA-2), zinc transporter 8 (ZnT8), together with thyroid peroxidase Ab (TPO Ab), thyroglobulin Ab (Tg Ab), tissue transglutaminase Ab (tTG Ab) and 21-hydroxylase Ab (21-OH Ab) were measured. Results: The prevalence of at least one diabetes associated Ab was found in 87%, with the highest prevalence of 64% for ZnT8 Ab. In patients with disease duration < 5 years, at least one antibody was present in 90%, the most prevalent was ZnT8 Ab (72%). In patients with duration > 10 years, 50% had at least one antibody. The prevalence of other than islet cell autoimmunity was high (34%). Thyroid Ab were detected in 26% patients, 42% in girls vs. 8% in boys, p < 0.001. tTG Ab were found in 11% patients, with a greater prevalence in children with early onset (p = 0.01). 21-OH Ab were found in 2.6% T1DM patients.

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Autoantibody “Subspecificity” in Type 1 Diabetes

Cited by 163 publications

References 42 publications

Prevalence of Anti-Thyroid Peroxidase in Adults with Type 1 Diabetes Participating in Poznań Prospective Study

Prevalence of Anti-Thyroid Peroxidase in Adults with Type 1 Diabetes Participating in Poznań Prospective Study

Thyroid autoimmunity in relation to islet autoantibodies and HLA-DQ genotype in newly diagnosed type 1 diabetes in children and adolescents

Organ-specific autoimmunity in relation to clinical characteristics in children with long-lasting type 1 diabetes

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