High titre of antiglutamic acid decarboxylase autoantibody is a strong predictor of the development of thyroid autoimmunity in patients with type 1 diabetes and latent autoimmune diabetes in adults

Park, Jin; Huang, Gan; Lin, Jian; Yang, Lin; Xiang, Bin; Zhou, Weidong; Zhang, Zhou

doi:10.1111/j.1365-2265.2011.03976.x

Cited by 64 publications

(80 citation statements)

References 36 publications

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“…The screening performed should at least include thyroid-stimulating hormone (TSH) and anti-thyroid peroxidase autoantibody (ATPO) evaluation (16). In light of the previous studies, especially individuals with high GADA titres should be assessed to determine possible thyroid dysfunction (17).…”

Section: Introductionmentioning

confidence: 99%

Are zinc transporter type 8 antibodies a marker of autoimmune thyroiditis in non-obese adults with new-onset diabetes?

Rogowicz-Frontczak

Zozulińska‐Ziółkiewicz

Litwinowicz

et al. 2014

European Journal of Endocrinology

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Objective: The diagnosis of autoimmune diabetes in non-obese adults is based on the detection of glutamic acid decarboxylase autoantibodies (GADA), islet cell antibodies (ICA) and antibodies to tyrosine phosphatase (IA-2A). Zinc transporter 8 (ZnT8) has been identified as a new autoantigen in patients with type 1 diabetes mellitus. The coincidence of autoimmune thyroiditis (AITD) with diabetes is common; therefore, screening of TSH and thyroid peroxidase antibodies (ATPO) is recommended during the diagnosis of diabetes. In this study, we determined whether the occurrence of islet autoantibodies is associated with a positive titre of ATPO in newly diagnosed adult-onset autoimmune diabetic patients. Results: In the study population, 70% (nZ56) of the subjects were positive for at least one of the four assessed markers of autoimmune diabetes (83.9% GADA, 62.5% ICA, 42.8% IA-2A and 33% ZnT8A) and 37.5% of the subjects were positive for ATPO. The ZnT8A-positive subjects had higher ATPO titres than the ZnT8A-negative subjects (172.7 (IQR: 0.36-410.4) vs 92.4 (IQR: 0-23.7) IU/ml, PZ0.001). Based on the assessed islet autoantibodies, the occurrence of positive ZnT8A and GADA was found to be related to a positive titre of ATPO using logistic regression (ORZ5.48, 95% CI: 1.65-18.14, PZ0.006 and ORZ3.42, 95% CI: 1.09-10.71, PZ0.03 respectively). Conclusions: In non-obese adults with new-onset diabetes, the presence of GADA and especially ZnT8 autoantibodies increases the risk of AITD.

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Section: Introductionmentioning

confidence: 99%

Are zinc transporter type 8 antibodies a marker of autoimmune thyroiditis in non-obese adults with new-onset diabetes?

Rogowicz-Frontczak

Zozulińska‐Ziółkiewicz

Litwinowicz

et al. 2014

European Journal of Endocrinology

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“…Several cross-sectional studies have shown that GADA titers are associated with the phenotypic heterogeneity of clinical features in LADA patients (11)(12)(13)(14)(15)(16). The apparent bimodal distribution of GADA titers can be used to classify LADA into two subgroups with distinct clinical, autoimmune, and genetic features (13)(14)(15).…”

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confidence: 99%

Latent Autoimmune Diabetes in Adults With Low-Titer GAD Antibodies: Similar Disease Progression With Type 2 Diabetes

Liu

Xiang

et al. 2014

Diabetes Care

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OBJECTIVEThis study investigated the relationship between GAD autoantibody (GADA) titers and changing of b-cell function in patients with latent autoimmune diabetes in adults (LADA). RESEARCH DESIGN AND METHODSThis 3-year prospective study enrolled 95 subjects from 15 Chinese cities including 25 high-titer (GADA ‡180 units/mL) LADA patients, 42 low-titer (GADA <180 units/mL) LADA patients, and 28 type 2 diabetic patients, the latter two groups as controls of similar age, sex, and BMI. Clinical characteristics were determined annually, including glycosylated hemoglobin (HbA 1c ), fasting C-peptide (FCP), and 2-h postprandial C-peptide (PCP). RESULTSDespite similar initial FCP and PCP, FCP and PCP both decreased more in subjects with high GADA titer (FCP from mean 0.49 nmol/L at entry to 0.13 nmol/L at the third year; P < 0.05) than with low GADA titer (FCP from mean 0.48 to 0.38 nmol/L) and type 2 diabetes (FCP from mean 0.47 to 0.36 nmol/L); the latter two groups being similar. After 3 years, residual b-cell function (FCP >0.2 nmol/L) was detected in only 42% with an initial high GADA titer compared with 90% with a low GADA titer and 97% with type 2 diabetes (P < 0.01 for both). GADA positivity at the third year persisted more in subjects with initially high GADA (92%) than with low GADA (26%) titers (P < 0.01). CONCLUSIONSIn selected LADA patients, initial GADA titers identified subjects with different degrees of persistent autoimmunity and disease progression. LADA patients with a low GADA titer had metabolic phenotypes and loss of b-cell function similar to type 2 diabetic patients.

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“…Although this study had a modest sample size, other small studies have identified similar results (2,3,9,19,(21)(22)(23)(24), including one in another sample of the Brazilian population (12). According to these authors, thyroid autoantibodies occur in 8% to 25% of FDR of T1DM patients.…”

Section: Discussionmentioning

confidence: 68%

“…There is increasing evidence of the role of subclinical asymptomatic hypothyroidism in the risk for cardiovascular diseases (17)(18)(19) and even TSH levels between 2.5 and 4.0 mU/liter have been linked to cardiovascular risk. The National Academy of Clinical Biochemistry has suggested that the cutoff for TSH levels should be < 2.5 mU/liter, based on the observation that 95% of the normal population has TSH levels within this range (20).…”

Section: Discussionmentioning

confidence: 99%

Thyroid disorders are common in first-degree relatives of individuals with type 1 diabetes mellitus

Araújo

Barone

Melleti

et al. 2015

Arch. Endocrinol. Metab.

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Objective: Thyroid diseases are common in individuals with type 1 diabetes mellitus (T1DM) and should be investigated annually in these individuals. The aim of this study was to evaluate the frequency of thyroid diseases in first degree relatives (FDR) of patients with T1DM. Subjects and me thods: Eighty individuals (40 patients with T1DM and 40 FDR) were interviewed and blood was sampled for thyroid-stimulating hormone (TSH), free thyroxine (FT4) and thyroid peroxidase (TPO) antibodies measurement. Autoantibodies against glutamic acid decarboxylase 65 (GAD65), islet antigen-2 (IA2) and autoantibodies against insulin (AAI) were measured in FDR. Results: We found a similar prevalence of thyroid dysfunction in patients with T1DM and their FDR (22.5% vs. 27.5%; p = 0,79). There were no differences in serum TSH levels (p = 0.29), FT4 (p = 0,45), frequency of abnormal TSH (p = 0.28), positive TPO antibodies (p = 0.13), titers of TPO antibodies (in positive cases) between patients with T1DM and their FDR (p = 0.94). Conclusions: Thyroid abnormalities seem to be common not only in patients with T1DM but also in their FDR, which suggests that screening strategies for thyroid diseases might also be useful to these individuals. Arch Endocrinol Metab. 2015;59(2):112-5

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High titre of antiglutamic acid decarboxylase autoantibody is a strong predictor of the development of thyroid autoimmunity in patients with type 1 diabetes and latent autoimmune diabetes in adults

Abstract: Regular screening of thyroid antibody and function are recommended, especially in patients with T1DM and LADA with high GADA titre.

Cited by 64 publications

References 36 publications

Are zinc transporter type 8 antibodies a marker of autoimmune thyroiditis in non-obese adults with new-onset diabetes?

Are zinc transporter type 8 antibodies a marker of autoimmune thyroiditis in non-obese adults with new-onset diabetes?

Latent Autoimmune Diabetes in Adults With Low-Titer GAD Antibodies: Similar Disease Progression With Type 2 Diabetes

Thyroid disorders are common in first-degree relatives of individuals with type 1 diabetes mellitus

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