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

Abstract

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.

Identification of autoimmune type 1 diabetes and multiple organ‐specific autoantibodies in adult‐onset non‐insulin‐requiring diabetes in China: A population‐based multicentre nationwide survey

“…Analysis of organ‐specific autoantibodies studied in our cohort showed that only 5.1% of people with adult‐onset non‐insulin‐requiring diabetes had more than one autoantibody (Table S5). Other studies in Chinese populations have confirmed a strong connection among various organ‐specific autoimmune diseases in T1D or LADA, and between coeliac disease and ATD . The present study showed that TPO and tTG autoantibodies are both associated with GAD autoantibodies, while people with tTG autoantibodies are at very high risk of IA2 autoantibody positivity and those with 21‐OH autoantibodies at risk of TPO autoantibody positivity.…”

“…Analysis of organ-specific autoantibodies studied in our cohort showed that only 5.1% of people with adult-onset non-insulin-requiring diabetes had more than one autoantibody (Table S5). Other studies in Chinese populations have confirmed a strong connection among various organ-specific autoimmune diseases in T1D or LADA, 12,16 and between coeliac disease and ATD. 30,31 The present study showed that Genetic susceptibility to ADM could explain many of the findings in the present study.…”

“…Importantly, follow‐up studies found that people with autoantibody‐positive diabetes have a more than fivefold risk of progression to insulin requirement compared with people who are autoantibody‐negative . In addition, ADM may co‐exist with a risk of other organ‐specific autoimmune diseases, including most commonly those involving the thyroid, small intestine and adrenal glands . Finally, the genetic characteristics of people with ADM are more closely related to T1D than T2D in both white and Chinese people, but the latter have fewer high‐risk histocompatibility antigen (HLA) alleles than the former .…”

“…[9][10][11] In addition, ADM may co-exist with a risk of other organ-specific autoimmune diseases 12,13 , including most commonly those involving the thyroid, small intestine and adrenal glands. [12][13][14][15][16][17] Finally, the genetic characteristics of people with ADM are more closely related to T1D than T2D in both white and Chinese people, but the latter have fewer high-risk histocompatibility antigen (HLA) alleles than the former. 3,18 These differences indicate the need for a different clinical strategy, with the need to consider early insulin treatment, and more frequent review and screening for comorbidities.…”

Organ-specific autoantibodies in Chinese patients newly diagnosed with type 1 diabetes mellitus

“…Previous studies have found that 15-30% of T1DM patients have comorbid autoimmune thyroid diseases, 0.97-16.7%, celiac disease; and 0.5-1%, Addison's disease [20], as evidenced by the presence of autoantibodies such as TPOA, TGA, tTGA and 21-OHA. A substantial proportion of T1DM patients seropositive for other organ-specific autoantibodies will progress to a clinical condition more complex and intractable than T1DM alone, so it is critical to identify subclinical comorbidities as early as possible by autoantibody screening [21]. In addition, careful monitoring of patients positive for organ-specific autoantibodies will facilitate early diagnosis of related diseases and timely clinical intervention.…”