Singh Shailja, Singh Gyanendra, Agrawal Neeraj Kumar, Singh Rana Gopal, Kumar Shashi Bhushan
Research Scholar, Department of Pathology, Institute of Medical Sciences, Banaras Hindu University , Varanasi, UP, India .
Professor and Incharge, UGC Advanced Immunodiagnostic Training and Research Centre, Department of Pathology, Institute of Medical Sciences, Banaras Hindu University , Varanasi, UP, India .
J Clin Diagn Res. 2016 Jul;10(7):EC09-13. doi: 10.7860/JCDR/2016/18657.8163. Epub 2016 Jul 1.
Type I diabetes Mellitus (T1DM) is caused by autoimmune destruction of β-cells of pancreas. Two forms of T1DM are known called as 1A (autoimmune) and 1B (idiopathic).
Aim was to study the prevalence of Anti-TTG IgA, Anti-TPO, GADA, ZnT8 and IA-2 autoantibodies and HLA DR and DQ genes and its diagnostic value in T1DM.
Thirty four T1DM patients, 59 type 2 diabetes mellitus (T2DM) patients and 28 healthy controls were included in study. Antibodies levels were estimated by ELISA and HLA typing was performed by SSP-PCR method.
The prevalence of various autoantibodies in T1DM were Anti-TTG 14.7%, Anti-TPO 17.65%, GADA 38.23%, ZnT8 11.76% and IA-2 5.88%. Only GADA and ZnT8 were significantly positive in T1DM. GADA (66.67%) and ZnT8 (33.33%) positivity was more in patients below 15 years age while levels of other antibodies were higher after 15 years age. All autoantibodies were detected in higher frequency in T1DM than in T2DM and controls. HLA DR and DQ typing showed highly significant increase in DRB10301 (61.76%, p=0.00) and DQB10201 (64.71%, p=0.00) in T1DM. Subjects with HLA DRB10301 and DQB10201 had 80-100% positive prevalence of GADA, ZnT8, IA-2, Anti-TTG and Anti-TPO autoantibodies.
Combination of GADA antibody with DRB1 and DQB1 estimation improved diagnosis of T1A than insulin antigen specific antibodies alone.
1型糖尿病（T1DM）是由胰腺β细胞的自身免疫性破坏引起的。已知T1DM有两种形式，即1A（自身免疫性）和1B（特发性）。
旨在研究抗组织转谷氨酰胺酶IgA、抗甲状腺过氧化物酶、谷氨酸脱羧酶自身抗体（GADA）、锌转运体8（ZnT8）和胰岛抗原2（IA-2）自身抗体以及人类白细胞抗原DR和DQ基因的患病率及其在T1DM中的诊断价值。
本研究纳入了34例T1DM患者、59例2型糖尿病（T2DM）患者和28例健康对照。通过酶联免疫吸附测定法（ELISA）估计抗体水平，并采用序列特异性引物聚合酶链反应（SSP-PCR）方法进行人类白细胞抗原分型。
T1DM中各种自身抗体的患病率分别为：抗组织转谷氨酰胺酶14.7%、抗甲状腺过氧化物酶17.65%、GADA 38.23%、ZnT8 11.76%和IA-2 5.88%。在T1DM中只有GADA和ZnT8呈显著阳性。15岁以下患者中GADA（66.67%）和ZnT8（33.33%）的阳性率更高，而其他抗体水平在15岁以后更高。所有自身抗体在T1DM中的检出频率均高于T2DM和对照组。人类白细胞抗原DR和DQ分型显示，T1DM中DRB10301（61.76%，p = 0.00）和DQB10201（64.71%，p = 0.00）显著增加。携带DRB10301和DQB10201的受试者中，GADA、ZnT8、IA-2、抗组织转谷氨酰胺酶和抗甲状腺过氧化物酶自身抗体的阳性患病率为80 - 100%。
与单独检测胰岛素抗原特异性抗体相比，联合检测GADA抗体与DRB1和DQB1可改善1A的诊断。
