Elmaoğulları Selin, Uçaktürk Seyit Ahmet, Elbeg Şehri, Döğer Esra, Tayfun Meltem, Gürbüz Fatih, Bideci Aysun
University of Health Sciences, Ankara Children’s Hematology and Oncology Training and Research Hospital, Clinic of Pediatric Endocrinology, Ankara, Turkey
Gazi University Faculty of Medicine, Department of Biochemistry, Ankara, Turkey
J Clin Res Pediatr Endocrinol. 2018 Jun 1;10(2):108-112. doi: 10.4274/jcrpe.5020. Epub 2017 Sep 25.
Zinc transporter 8 protein (ZnT8A) is a transmembrane protein which functions to transfer zinc to insulin vesicles. Antibodies formed against ZnT8A (ZnT8A) are regarded as an independent autoimmunity demonstrator in type 1 diabetes (T1D). The aim of this study was to investigate the prevalence of ZnT8A in Turkish children with new onset T1D.
Eighty four patients between 1-18 years of age diagnosed with T1D between February 2015-March 2016 and the control group consisting of 50 healthy children without any autoimmune diseases were included in the study. Serum samples for ZnT8A testing were taken from the patient group within a week of diagnosis. A ZnT8A enzyme-linked immunosorbent assay was used in the analyses.
ZnT8A positivity was detected in 58% of the patients with new onset T1D and 8% of the control group. ZnT8A were demonstrated in 5 of 11 patients with negative results for classical diabetes antibodies [insulinoma antigen-2 antibody (IA-2A), glutamic acid decarboxylase (GAD) or insulin autoantibodies]. No association was found between ZnT8A positivity and age, gender, presence or degree of ketoacidosis at presentation, hemoglobin A1c, insulin or C-peptide concentration, or the presence of either thyroid or celiac antibodies.
ZnT8A prevalence in children with T1D in Turkey was compatible with the literature. The ratio of patients who are clinically considered to have T1D but have negative routine diabetes auto-antibodies were observed to decrease nearly by 50% when ZnT8 antibodies were added to the panel. ZnT8 measurement should be more widespread for clarifying the etiology in T1D.
锌转运体8蛋白（ZnT8A）是一种跨膜蛋白，其功能是将锌转运至胰岛素囊泡。针对ZnT8A产生的抗体被视为1型糖尿病（T1D）中一种独立的自身免疫标志物。本研究的目的是调查土耳其新诊断T1D儿童中ZnT8A的流行情况。
本研究纳入了2015年2月至2016年3月期间诊断为T1D的84例1至18岁患者以及由50名无任何自身免疫性疾病的健康儿童组成的对照组。在诊断后一周内从患者组采集用于检测ZnT8A的血清样本。分析中采用了ZnT8A酶联免疫吸附测定法。
新诊断的T1D患者中有58%检测到ZnT8A阳性，对照组中有8%检测到ZnT8A阳性。在11例经典糖尿病抗体[胰岛素瘤相关抗原2抗体（IA-2A）、谷氨酸脱羧酶（GAD）或胰岛素自身抗体]检测结果为阴性的患者中，有5例检测到ZnT8A。未发现ZnT8A阳性与年龄、性别、就诊时酮症酸中毒的存在或程度、糖化血红蛋白、胰岛素或C肽浓度，或甲状腺或乳糜泻抗体的存在之间存在关联。
土耳其T1D儿童中ZnT8A的流行情况与文献报道相符。当在检测项目中加入ZnT8抗体时，临床上被认为患有T1D但常规糖尿病自身抗体检测结果为阴性的患者比例下降了近50%。为明确T1D的病因，ZnT8检测应更广泛应用。
