Islet cell, thyroid, adrenal and celiac disease related autoantibodies in patients with Type 1 diabetes from Sri Lanka

Premawardhana, Lakdasa; Wijeyaratne, CN; Chen, S.; Wijesuriya, Mahen; Illangasekera, Upali; Brooking, Helen; Amoroso, Marie; Jeffreys, Jennifer; Bolton, Jane; Lazarus, John H.; Furmaniak, Jadwiga; Smith, Bernard Rees

doi:10.1007/bf03349209

Cited by 13 publications

(10 citation statements)

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“…In the present study, the rate of positive anti-TPO and/or anti-TG was 20.2% and 10.3% in the patient and control groups, respectively. In the study by Premawardhana et al, patient and control groups had an anti-TG positivity of 25% and 33%, respectively, and for anti-TPO, these rates were as 22% and 18%, respectively; there was no statistical difference between these groups [22]. Previous studies have reported that TA is more frequent among girls than boys [21,23], while the present authors and others [19,24] have not found such a difference.…”

Section: Discussioncontrasting

confidence: 45%

“…This difference was not statistically significant when compared with the 22% positivity among cases negative for anti-GAD [10]. Premawardhana et al did not find any statistical difference between anti-GAD65/anti-IA-2 positive and negative type 1 DM patients in terms of TA [22]. This may reflect ethnic differences, difference in iodine intake, or genetic heterogeneity in the role of TA and anti-GAD autoimmunity in type 1 DM with thyroid autoimmunity.…”

Section: Discussionmentioning

confidence: 88%

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Autoimmune thyroid disease in patients with anti-GAD positive type 1 diabetes mellitus

et al. 2009

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AbstractThe aim of the study was to determine the frequency and titers of anti-thyroid peroxidase (Anti-TPO), anti-thyroglobulin (Anti-TG), and anti-glutamic acid decarboxylase (Anti-GAD) antibodies in Turkish patients with type 1 diabetes mellitus (DM), and to compare the frequency of anti-TPO and anti-TG titers in the presence or absence of anti-GAD. A total of 104 patients including 56 males and 48 females with type 1 DM and their age-, gender-, and body mass index-matched control group, including 31 males and 27 females, 58 cases in total with an age range of 15-50 years, were recruited into this study. In patients with type 1 DM, positive anti-GAD was detected in 30.8% (n=32). In patients with positive anti-GAD, rate of positive anti-TPO was 37.5%; however, in patients with negative anti-GAD, the rate of positive anti-TPO was 9.7% and the difference was statistically significant (p=0.001). In patients with positive anti-GAD, the rate of positive anti-TG was 18.8%. In patients with negative anti-GAD, the rate of positive anti-TG was 2.8%, and the difference between them was statistically significant (p=0.005). In patients with positive and negative anti-GAD, rates of both positive anti-TPO and anti-TG were 15.6% and 1.4%, respectively, with the difference showing statistical significance (p=0.004). Thyroid autoimmunity in type 1 DM patients with positive anti-GAD was apparently higher; therefore, these patients should be followed more frequently and carefully.

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Section: Discussioncontrasting

confidence: 45%

Section: Discussionmentioning

confidence: 88%

Autoimmune thyroid disease in patients with anti-GAD positive type 1 diabetes mellitus

et al. 2009

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“…These TgAbs were not associated with thyroid dysfunction and probably represented a non-pathological antibody response to iodination (6). Recently, we also reported a high frequency of TgAbs in Sri Lankan patients with T1DM (7). The clinical significance of TgAbs in these diabetic patients is thus unclear and a point of interest is whether they indicate thyroiditis or whether they simply represent a non-pathological effect of iodination.…”

Section: Introductionmentioning

confidence: 74%

“…Details of the prevalence of other disease-associated antibodies in the group have been described elsewhere (7). T1DM was diagnosed according to WHO criteria (13).…”

Section: Subjectsmentioning

confidence: 99%

Restricted thyroglobulin antibody epitope specificities in subjects with type 1 diabetes mellitus

Okosieme¹,

Wijeyaratne²,

Lazarus³

et al. 2009

European Journal of Endocrinology

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Objectives: Following iodisation in Sri Lanka we observed a high prevalence of thyroglobulin antibodies (TgAbs) in type 1 diabetic (T1DM) patients. The clinical significance of these TgAbs is uncertain. We sought to obtain a detailed epitope analysis of TgAbs in T1DM patients recruited from diabetes clinics and to compare these with TgAb epitope specificities in patients with autoimmune thyroid disease (AITD) and healthy individuals in that country. Design and methods: We used a panel of 10 Tg-MAbs in competitive ELISA reactions in a prospective study of subjects recruited from Colombo, to determine the epitopes recognised by TgAb-positive patients with T1DM (nZ58, 34F:24M, median age 16 years), AITD patients (nZ42, 33F:9M, median age 37 years) and healthy subjects (nZ50, 39F:11M, median age 27 years). The outcomes were a comparison of reactivity with six Tg clusters (I-VI) in these subjects, and the relation of epitope specificity patterns with free thyroxine and TSH. Results: Patients with T1DM and AITD but not healthy control subjects preferentially recognised the immunodominant clusters, I, III and IV. Patients with these narrow epitope specificities had higher median TSH levels (1.60 vs 1.06; PZ0.01), and were more frequently positive for antibodies to thyroid peroxidase than those with broad specificities (52.3 vs 7.1%; PZ0.004). Conclusions: The TgAb epitope specificities in euthyroid Sri Lankans with T1DM are similar to AITD patients. TgAb epitope studies may potentially identify T1DM patients at risk of thyroid dysfunction.

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“…(a) diagnosing T1D - there are only sparse data about T1D related autoantibody prevalence either at diagnosis or thereafter in Sri Lankan children ( 9 ). Sensitive assays for T1D related autoantibodies identify variable percentages of antibody positive subjects at diagnosis and in established T1D, associated with regional variability, as described in a recent review ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

The prevalence of diabetes and thyroid related autoantibodies in Sri Lankan children with type 1 diabetes and their unaffected siblings – The utility of a new screening assay

Amoroso¹,

Powell²,

Silva³

et al. 2023

Front. Endocrinol.

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BackgroundThere is limited information about diabetes and thyroid related autoantibodies in children with type 1 diabetes (T1D) or their siblings in Sri Lanka.ObjectivesTo assess in T1D children and their unaffected siblings the prevalence of autoantibodies to (1) glutamic acid decarboxylase (GADA), insulinoma associated antigen-2 (IA-2A) and zinc transporter 8 (ZnT8A) using 3 Screen ICA™ (3-Screen) and individual ELISA assays; (2) insulin (IAA); and (3) thyroid peroxidase (TPOA), thyroglobulin (TgA) and the TSH receptor (TSHRA).MethodsWe selected - (a) consecutive T1D children, and (b) their unaffected siblings of both sexes, from the T1D Registry at Lady Ridgeway Hospital, Colombo.ResultsThe median age (IQR) of 235 T1D children and 252 unaffected siblings was 11 (8.4, 13.2) and 9 (5.4, 14.9) years respectively, and the duration of T1D was 23 (7, 54) months. (1) T1D children (a) 79.1% were 3-Screen positive; (b) all 3-Screen positives were individual antibody positive (GADA in 74%; IA-2A 31.1%; ZnT8A 38.7%); (c) and were younger (p=0.01 vs 3-Screen negatives); (d) multiple autoantibodies were present in 45.1%; (e) IA-2A (p=0.002) and ZnT8A (p=0.006) prevalence decreased with T1D duration. (f) TPOA and TgA prevalence was higher in T1D children compared to unaffected siblings (28%, p=0.001 and 31%, p=0.004, respectively). (2) Unaffected siblings (a) 6.3% were 3-Screen positive (p=0.001 vs T1D), and 2.4% were positive for IAA; (b) four subjects had two diabetes related autoantibodies, one of whom developed dysglycaemia during follow-up.ConclusionsThe 3-Screen assay, used for the first time in Sri Lankan T1D children and their siblings as a screening tool, shows a high prevalence of T1D related Abs with a high correlation with individual assays, and is also a helpful tool in screening unaffected siblings for future T1D risk. The higher prevalence of thyroid autoantibodies in T1D children is consistent with polyglandular autoimmunity.

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Islet cell, thyroid, adrenal and celiac disease related autoantibodies in patients with Type 1 diabetes from Sri Lanka

Cited by 13 publications

References 50 publications

Autoimmune thyroid disease in patients with anti-GAD positive type 1 diabetes mellitus

Autoimmune thyroid disease in patients with anti-GAD positive type 1 diabetes mellitus

Restricted thyroglobulin antibody epitope specificities in subjects with type 1 diabetes mellitus

The prevalence of diabetes and thyroid related autoantibodies in Sri Lankan children with type 1 diabetes and their unaffected siblings – The utility of a new screening assay

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