Poznan University of Medical Sciences, Poznan, Poland.
Poznan University of Medical Sciences, Poznan, Poland.
Diabetes Res Clin Pract. 2018 Dec;146:313-320. doi: 10.1016/j.diabres.2018.11.007. Epub 2018 Nov 19.
The study aimed to assess the prevalence of zinc transporter 8 autoantibodies (ZnT8-ab), other diabetes-related autoantibodies and clinical manifestation of type 1 diabetes in adults, depending on age of the onset of disease.
119 patients with type 1 diabetes, 66 at age <35 years (T1DM < 35) and 53 T1DM at age ≥35 years (T1DM ≥ 35). We assessed clinical features, GAD-ab, IA2-ab, ICA, ZnT8-ab and thyroid peroxidase antibodies (ATPO).
In T1DM < 35 lower initial serum C-peptide concentration was observed and diabetes ketoacidosis (DKA) was more common. ATPO positivity was more prevalent in T1DM ≥ 35 (35.8 vs 21.2%, p = 0.04). The prevalence of GAD-ab, IA2-ab and ZnT8-ab was similar in both groups, the titres of IA2-ab and ICA were higher in T1DM < 35 but titre of ZnT8-ab was higher in T1DM ≥ 35. The majority of T1DM < 35 patients were positive for three autoantibodies (40.9%), while T1DM ≥ 35 subjects most often presented with only one (30.2%) antibody, most commonly GAD-ab (81.2%). 45% T1DM < 35 and 34% T1DM ≥ 35 subjects were positive for ZnT8-ab. ZnT8-ab positive patients had higher titre and more frequent occurrence of multiple diabetes-related autoantibodies than ZnT8-ab negative patients.
Adults with T1DM < 35 and T1DM ≥ 35 differ in the severity of autoimmune response at diagnosis. ZnT8-ab positivity is related to higher titre and more frequent occurrence of multiple diabetes-related autoantibodies.
本研究旨在评估成人发病年龄不同的 1 型糖尿病患者（T1DM）中锌转运体 8 自身抗体（ZnT8-ab）、其他糖尿病相关自身抗体的流行率以及 1 型糖尿病的临床表现。
119 名 1 型糖尿病患者，66 名发病年龄<35 岁（T1DM<35），53 名发病年龄≥35 岁（T1DM≥35）。我们评估了临床特征、GAD-ab、IA2-ab、ICA、ZnT8-ab 和甲状腺过氧化物酶抗体（ATPO）。
T1DM<35 岁的患者初始血清 C 肽浓度较低，且糖尿病酮症酸中毒（DKA）更为常见。T1DM≥35 岁患者中 ATPO 阳性更为常见（35.8%比 21.2%，p=0.04）。两组 GAD-ab、IA2-ab 和 ZnT8-ab 的患病率相似，T1DM<35 岁患者的 IA2-ab 和 ICA 滴度较高，但 T1DM≥35 岁患者的 ZnT8-ab 滴度较高。大多数 T1DM<35 岁患者呈三种自身抗体阳性（40.9%），而 T1DM≥35 岁患者最常呈一种（30.2%）抗体阳性，最常见的是 GAD-ab（81.2%）。45%的 T1DM<35 岁和 34%的 T1DM≥35 岁患者呈 ZnT8-ab 阳性。ZnT8-ab 阳性患者的抗体滴度较高，且更常发生多种糖尿病相关自身抗体。
发病年龄不同的成人 T1DM 患者在诊断时自身免疫反应的严重程度不同。ZnT8-ab 阳性与较高的抗体滴度和更常发生多种糖尿病相关自身抗体有关。
