Department of Pediatric Endocrinology, Diabetes Research Center of Mazandaran, Mazandaran University of Medical Sciences, Sari, Iran.
Department of Epidemiology, Ischemic Disorders Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
J Pediatr Endocrinol Metab. 2020 Aug 17;33(10):1299-1305. doi: 10.1515/jpem-2019-0396.
Objectives Type 1 diabetes is an autoimmune disease. Its most important immunologic markers are pancreatic beta-cell autoantibodies. This study aimed to determine diabetes mellitus antibodies frequency among children and adolescents with type 1 diabetes. Methods This descriptive study evaluated the frequency of four diabetes autoantibodies (glutamic acid decarboxylase 65 autoantibodies [GADA], islet cell autoantibodies [ICA], insulin autoantibodies [IAA], tyrosine phosphatase-like insulinoma antigen-2 antibodies [IA-2A]) and their serum level in children and adolescents diagnosed with type 1 diabetes mellitus at the diabetes department of Bou-Ali-Sina Hospital and Baghban Clinic, Sari, Iran, from March 2012 to March 2018. The relationship between the level of different antibodies and age, gender, and diabetes duration were determined. A two-sided p value less than 0.05 indicated statistical significance. Results One hundred forty-two eligible patient records were screened. The average age at diabetes diagnosis was 4.2 ± 4.4 years. The median duration of diabetes was 34.0 (12.7-69.7) months. 53.5% of patients were female, and 81.7% of them had at least one positive autoantibody, and ICA in 66.2%, GADA in 56.3%, IA-2A in 40.1%, and IAA in 21.8% were positive. The type of the autoantibodies and their serum level was similar between females and males but there was a higher rate of positive autoantibodies in females. The level of IA-2A and ICA were in positive and weak correlation with age at diagnosis. Conclusions More than 80% of pediatric and adolescent patients with type 1 diabetes were autoantibody-positive. ICA and GADA were the most frequently detected autoantibodies. The presence of antibodies was significantly higher in females.
目的
1 型糖尿病是一种自身免疫性疾病。其最重要的免疫标志物是胰岛β细胞自身抗体。本研究旨在确定 1 型糖尿病患儿和青少年糖尿病抗体的频率。
方法
本描述性研究评估了 4 种糖尿病自身抗体(谷氨酸脱羧酶 65 自身抗体 [GADA]、胰岛细胞自身抗体 [ICA]、胰岛素自身抗体 [IAA]、酪氨酸磷酸酶样胰岛素瘤抗原-2 抗体 [IA-2A])及其血清水平在 2012 年 3 月至 2018 年 3 月期间,伊朗萨里的 Bou-Ali-Sina 医院和 Baghban 诊所的 1 型糖尿病患儿和青少年中的频率。确定不同抗体的水平与年龄、性别和糖尿病持续时间之间的关系。双侧 p 值小于 0.05 表示具有统计学意义。
结果
筛选了 142 份符合条件的患者记录。糖尿病诊断时的平均年龄为 4.2±4.4 岁。糖尿病的中位病程为 34.0(12.7-69.7)个月。53.5%的患者为女性,其中 81.7%至少有一种自身抗体阳性,ICA 阳性率为 66.2%,GADA 阳性率为 56.3%,IA-2A 阳性率为 40.1%,IAA 阳性率为 21.8%。女性和男性的自身抗体类型及其血清水平相似,但女性自身抗体阳性率较高。IA-2A 和 ICA 的水平与诊断时的年龄呈正相关和弱相关。
结论
超过 80%的 1 型糖尿病儿童和青少年患者为自身抗体阳性。ICA 和 GADA 是最常检测到的自身抗体。女性抗体阳性率明显更高。