Karavanaki Kyriaki, Kakleas Kostas, Paschali Evangelia, Kefalas Nikos, Konstantopoulos Ilias, Petrou Vassilis, Kanariou Maria, Karayianni Christina
Diabetic Clinic, B' Pediatric Department, University of Athens, 'P. & A. Kyriakou' Children's Hospital, Athens, Greece.
Horm Res. 2009;71(4):201-6. doi: 10.1159/000201108. Epub 2009 Mar 4.
BACKGROUND/AIMS: Type 1 diabetes (T1DM) is associated with autoimmune thyroid, celiac, autoimmune gastric and Addison's disease. Our aim was to investigate the prevalence of associated autoantibodies in relation to the demographic and beta-cell autoantibody status (anti-GAD).
Antibodies against thyroid peroxidase (anti-TPO), thyroglobulin (anti-Tg), tissue transglutaminase (anti-tTG IgA), parietal cells (APCA) and adrenal tissue (AAA) were measured in 144 children with T1DM with a mean +/- SD age of 12.3 +/- 4.6 years and a diabetes duration of 4.6 +/- 3.8 years.
The prevalence of antibody positivity among our patients was: anti-GAD 53.2%, anti-thyroid (anti-TPO 17.4%, anti-Tg 11.1%); anti-tTG IgA 7.6%, APCA 4.0%, and AAA 0%. Among the children with positive anti-thyroid antibodies, 60% developed autoimmune thyroiditis, while among those anti-tTG IgA positive, 62.5% developed biopsy-confirmed celiac disease. Female gender was more frequent among anti-tTG IgA-positive patients (OR 4.47, p = 0.068), while increasing age was associated with anti-Tg positivity (OR 22.9, p = 0.041). The presence of anti-thyroid antibodies was associated with the presence of anti-GAD (OR 1.45, p = 0.01) and parietal cell antibodies (OR 4.98, p = 0.09).
Among T1DM patients, the prevalence rates of anti-thyroid and parietal cell antibodies increased with age and diabetes duration. As the presence of anti-GAD was associated with gastric and thyroid autoimmunity, it could serve as marker for the development of additional autoimmunity in adolescents with diabetes.
背景/目的：1型糖尿病（T1DM）与自身免疫性甲状腺疾病、乳糜泻、自身免疫性胃炎及艾迪生病相关。我们的目的是调查相关自身抗体的患病率与人口统计学及β细胞自身抗体状态（抗谷氨酸脱羧酶抗体，anti-GAD）之间的关系。
对144例T1DM儿童进行检测，这些儿童的平均年龄为12.3±4.6岁，糖尿病病程为4.6±3.8年，检测其抗甲状腺过氧化物酶抗体（anti-TPO）、抗甲状腺球蛋白抗体（anti-Tg）、抗组织转谷氨酰胺酶抗体（抗tTG IgA）、抗壁细胞抗体（APCA）及抗肾上腺组织抗体（AAA）。
我们的患者中抗体阳性率分别为：抗GAD 53.2%，抗甲状腺抗体（anti-TPO 17.4%，anti-Tg 11.1%）；抗tTG IgA 7.6%，APCA 4.0%，AAA 0%。在抗甲状腺抗体阳性的儿童中，60%发生了自身免疫性甲状腺炎，而在抗tTG IgA阳性的儿童中，62.5%经活检确诊为乳糜泻。抗tTG IgA阳性患者中女性更为常见（比值比4.47，p = 0.068），而年龄增加与抗Tg阳性相关（比值比22.9，p = 0.041）。抗甲状腺抗体的存在与抗GAD（比值比1.45，p = 0.01）及抗壁细胞抗体（比值比4.98，p = 0.09）的存在相关。
在T1DM患者中，抗甲状腺及抗壁细胞抗体的患病率随年龄及糖尿病病程增加。由于抗GAD的存在与胃及甲状腺自身免疫相关，它可作为糖尿病青少年发生其他自身免疫性疾病的标志物。
