Basu Madhurima, Pandit Kaushik, Banerjee Mainak, Mondal Samim Ali, Mukhopadhyay Pradip, Ghosh Sujoy
Department of Endocrinology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India.
Indian J Endocrinol Metab. 2020 May-Jun;24(3):256-259. doi: 10.4103/ijem.IJEM_63_20. Epub 2020 Jun 30.
Type 1 diabetes is associated with several disease-related and other organ-specific autoimmune disorders. Data related to various auto-antibodies in Type 1 diabetes in India is limited.
In this cross sectional study, 92 subjects with T1DM (33 males, 59 females) were evaluated for T1DM related antibodies (autoantibodies to glutamic acid decarboxylase (anti-GAD), autoantibodies to protein tyrosine phosphatise (anti-IA2), anti-islet cell antibody (ICA), insulin autoantibody (IAA), anti-Zinc Transporter(ZnT8) and other organ specific auto antibodies like anti-thyroid peroxidase (anti-TPO), anti-thyroglobulin (TgAb), IgA anti-tissue transglutaminase (IgA anti-tTG), anti-21-hydroxylase, and anti-ovarian antibody (in females).
Anti-GAD, IA-2, islet cell antibody, insulin autoantibodies (IAA), ZnT8 antibody were present in 79.3%, 32.6%, 61.9%, 63%, and 20.65% subjects, respectively. Only 2.2% patients with Type 1 diabetes were antibody negative. At least one antibody was found in 97.8% and at least two antibodies in 67.3%. The presence of anti-TPO, anti-thyroglobulin, IgA anti-tissue transglutaminase, anti 21-hydroxylase were found in 51%, 25%, 22.8%, and 2.1%, respectively. Anti-ovarian antibody was absent in all females of our study population. The duration of diabetes positively correlated with the number of T1DM specific antibody and also with GAD antibody positivity. Anti TPO positivity correlated with the age of onset of T1DM, but not with the duration of disease or presence of other T1DM specific autoantibody.
T1DM is associated with a high prevalence of autoantibodies and antibody negative T1DM is rare. The association with other organ specific antibody (especially thyroid and adrenal glands) and celiac disease is also substantial, which reinforces the importance of regular thyroid and celiac disease screening in T1DM subjects. The duration of diabetes positively correlated with number of T1DM specific antibodies.
1型糖尿病与多种疾病相关及其他器官特异性自身免疫性疾病有关。印度1型糖尿病患者各种自身抗体的相关数据有限。
在这项横断面研究中，对92例1型糖尿病患者（33例男性，59例女性）进行了1型糖尿病相关抗体（谷氨酸脱羧酶自身抗体（抗GAD）、蛋白酪氨酸磷酸酶自身抗体（抗IA2）、抗胰岛细胞抗体（ICA）、胰岛素自身抗体（IAA）、抗锌转运体（ZnT8））以及其他器官特异性自身抗体（如抗甲状腺过氧化物酶（抗TPO）、抗甲状腺球蛋白（TgAb）、IgA抗组织转谷氨酰胺酶（IgA抗tTG）、抗21-羟化酶和抗卵巢抗体（女性））的评估。
抗GAD、IA-2、胰岛细胞抗体、胰岛素自身抗体（IAA）、ZnT8抗体分别在79.3%、32.6%、61.9%、63%和20.65%的受试者中存在。仅2.2%的1型糖尿病患者抗体阴性。97.8%的患者至少有一种抗体呈阳性，67.3%的患者至少有两种抗体呈阳性。抗TPO、抗甲状腺球蛋白、IgA抗组织转谷氨酰胺酶、抗21-羟化酶的阳性率分别为51%、25%、22.8%和2.1%。本研究人群中的所有女性均未检测到抗卵巢抗体。糖尿病病程与1型糖尿病特异性抗体数量以及GAD抗体阳性呈正相关。抗TPO阳性与1型糖尿病的发病年龄相关，但与疾病病程或其他1型糖尿病特异性自身抗体的存在无关。
1型糖尿病患者自身抗体的患病率较高，抗体阴性的1型糖尿病罕见。与其他器官特异性抗体（尤其是甲状腺和肾上腺）及乳糜泻的关联也很显著，这凸显了对1型糖尿病患者定期进行甲状腺和乳糜泻筛查的重要性。糖尿病病程与1型糖尿病特异性抗体数量呈正相关。
