Department of Clinical Sciences, Lund University, Lund, Sweden.
Diabet Med. 2012 Dec;29(12):e436-9. doi: 10.1111/j.1464-5491.2012.03766.x.
Gestational diabetes mellitus affects approximately 7% of all pregnant women. Some of these women develop autoantibodies that are generally characteristic of Type 1 diabetes. Autoantibodies targeting glutamic acid decarboxylase and tyrosine phosphatase-like protein are the most frequently reported. A recently identified autoantigen in Type 1 diabetes is zinc transporter 8. Some reports suggest that the frequency of zinc transporter 8 antibodies is as high as glutamic acid decarboxylase antibodies in Type 1 diabetes and thus a good diagnostic marker for autoimmune diabetes. There are currently no reports of zinc transporter 8 antibodies in gestational diabetes. The aim of this pilot study was to investigate the frequency of zinc transporter 8 antibodies in patients at clinical onset of gestational diabetes mellitus.
Subjects included in this pilot study were all diagnosed with gestational diabetes at Skåne University Hospital, Lund, Sweden, 2009-2010 (n = 193). Sera samples were analysed for antibodies using a commercial enzyme-linked immunosorbent assay according to the manufacturers' instructions.
We found that 19/193 patients with gestational diabetes, diagnosed in 2009-2010, were positive for at least one autoantibody. Glutamic acid decarboxylase was the most common single autoantibody (52.6%; 10/19), followed by zinc transporter 8 (21.1%; 4/19) and tyrosine phosphatase-like protein (15.8%; 3/19). Combinations of two or more antibodies were rare (10.5%; 2/19).
In this study, we found that zinc transporter 8 added 2.1% (4/193) of autoantibody positivity in women with gestational diabetes who were negative for glutamic acid decarboxylase and tyrosine phosphatase-like protein antibodies. Glutamic acid decarboxylase was still the most prevalent autoantibody in gestational diabetes, but, as zinc transporter 8 was present even in the absence of glutamic acid decarboxylase, this autoantibody could be an important independent marker of autoimmunity in gestational diabetes.
妊娠期糖尿病影响约 7%的孕妇。其中一些妇女产生通常与 1 型糖尿病相关的自身抗体。谷氨酸脱羧酶和酪氨酸磷酸酶样蛋白是最常报告的自身抗体。最近在 1 型糖尿病中发现的一种自身抗原是锌转运体 8。一些报告表明，锌转运体 8 抗体的频率与 1 型糖尿病中的谷氨酸脱羧酶抗体一样高，因此是自身免疫性糖尿病的良好诊断标志物。目前尚无妊娠期糖尿病中锌转运体 8 抗体的报告。本研究的目的是调查在临床确诊的妊娠期糖尿病患者中锌转运体 8 抗体的频率。
本研究纳入了 2009-2010 年在瑞典隆德斯科讷大学医院诊断为妊娠期糖尿病的 193 名患者。根据制造商的说明，使用商业酶联免疫吸附试验分析血清样本中的抗体。
我们发现，2009-2010 年诊断的 193 名妊娠期糖尿病患者中有 19 名（19/193）至少有一种自身抗体阳性。谷氨酸脱羧酶是最常见的单一自身抗体（52.6%；10/19），其次是锌转运体 8（21.1%；4/19）和酪氨酸磷酸酶样蛋白（15.8%；3/19）。两种或多种抗体的组合很少见（10.5%；2/19）。
在这项研究中，我们发现，在谷氨酸脱羧酶和酪氨酸磷酸酶样蛋白抗体阴性的妊娠期糖尿病妇女中，锌转运体 8 抗体阳性增加了 2.1%（4/193）。谷氨酸脱羧酶仍然是妊娠期糖尿病中最常见的自身抗体，但由于锌转运体 8 甚至在没有谷氨酸脱羧酶的情况下存在，因此该自身抗体可能是妊娠期糖尿病中自身免疫的一个重要独立标志物。
